腹腔镜联合提肛肌外腹会阴联合切除术治疗低位直肠癌近期效果分析  

Laparoscopic with extralevator abdominoperineal excision for low rectal carcinoma

作　　者：吴国举[1] 肖刚[1] 周新平[1] 赵刚[1] 贾文焯[1] 余涛[1] 安琦[1] 杨华[1] 龙海空[1] 黄美雄[1] 

机构地区：[1]卫生部北京医院普外科,100730

出　　处：《中华医学杂志》2013年第24期1921-1923,共3页National Medical Journal of China

摘　　要：目的探讨腹腔镜联合提肛肌外腹会阴联合切除术（LELAPE）在低位直肠癌治疗中的可行性。方法回顾性分析2011年6月至2013年1月北京医院胃肠外科35例低位直肠癌患者病例资料，20例行传统截石位腹腔镜腹会阴联合切除术（LAPE）者为LAPE组，其中男12例、女8例，平均年龄（63±6）岁；LELAPE组15例先取平卧位行腹腔镜腹部手术，再取折刀位行经提肛肌外会阴部手术，其中男10例、女5例，平均年龄（614-7）岁。应用t检验对比两组患者手术及术后恢复情况。结果LELAPE和LAPE组患者手术时间、术后开始下床活动时间、肠功能恢复时间、会阴部刀口拆线时间、术后住院时间差异均无统计学意义[（259±52）比（246±55）rain、（35±13）比（33±9）d，（61-4-25）比（63±20）h，（15．7±2．5）比（16．8±2．9）d，（12±3）比（154-4）d，均P〉0．05]；分另0发生2例和3例并发症（P〉0．05）；LELAPE组会阴部术中出血量更少、拔除会阴部引流管时间更早[（76±31）比（1484-36）ml，（6．2±1．6）比（10．34-1．8）d，均P〈0．05]。结论LELAPE治疗低位直肠癌安全可行，较传统截石位手术具有一定优势。Objective To explore the feasibility of laparoscopic with extralevator abdominoperineal excision （LELAPE group） for low rectal cancer. Methods From June 2011 to January 2013, 35 patients with low rectal cancer undergoing laparoscopic abdominoperineal excision at the Department of Gastroenterological Surgery, Beijing Hospital were analyzed retrospectively. Among them, 20 received laparoscopic abdominoperineal excision （LAPE group）. There were 12 males and 8 females with an average age of （63 ±ion （LELAPE group）. There were 10 males and 5 females with an average age of （61±7） years old. Operative duration, blood loss volume, time of postoperative out-of-bed activity, recovery of gastrointestinal function, removal time of drainage tube, edge of perineal position take out stitches time, postoperative hospital stay and complication rates were relative analyzed. Results There was no significant difference in operative time, time of postoperative out-of-bed activity, recovery of gastrointestinal function, removal time of perineal stitches, postoperative hospital stay and complication rates between 2 groups （ （259 ± 52） vs （246±55） min, （35±13） vs （33±9） d,（61±25） vs （63±20） h, （15.7±2.5） vs （16.8±2.9） d, （12 ± 3 ） vs （15 ± 4） d, 2/15 vs 3/20, all P 〉 0.05）. Blood loss volume of perineal position in LELAPE group was less than those in LAPE group （ （76 ± 31 ） vs （ 148 ± 36 ） ml, P 〈 0. 05 ）. Removal of perineal drainage tube in LELAPE group was earlier than that in LAPE group （ （6. 2 ± 1.6） vs （ 10. 3 ± 1.8） d, P 〈 O. 05）. Conclusion LELAPE is a safe and feasible surgical approach for low rectal cancer.

关 键 词：腹腔镜检查 直肠肿瘤 腹腔镜腹会阴联合切除术 

分 类 号：R735[医药卫生—肿瘤]