两种不同切口手助腹腔镜经腹会阴直肠癌根治术的比较  

Clinical effects of two different incisions with hand assisted laparoscopic Miles operation

作　　者：蒋会勇[1] 吕赤[1] 王希泽[1] 李谨[1] 张成[1] 张雪峰[1] 

机构地区：[1]解放军沈阳军区总医院普外科,辽宁沈阳110840

出　　处：《临床军医杂志》2013年第11期1135-1136,共2页Clinical Journal of Medical Officers

摘　　要：目的探讨腹正中切口及左侧腹部切口行手助腹腔镜(HALS)经腹会阴直肠癌根治术的临床效果。方法将2009年1月—2012年1月在我院住院的21例因直肠癌行手助腹腔镜经腹会阴直肠癌根治术患者,采用随机数字表随机分成两组,正中切口组及左下腹切口组。对两组手术的手术时间,失血量等指标进行比较。结果两组病例均顺利完成手助腹腔镜miles术,无中转开腹。两组平均手术时间、术中失血量、清除淋巴结数量、术后排气时间、住院时间及住院费用均无统计学差异(P>0.05)。但左下腹切口组腹部除造瘘口外仅留有两个戳口,腹部切口的创伤明显减小,美容效果较正中切口组好。结论对于应用手辅助腹腔镜技术行miles术的患者,相比腹正中切口,左下腹经腹直肌切口安置手助器创伤更小,美容效果更好。Objective To investigate the clinical effects of two different incisions with hand assisted laparoscopic Miles operation. Methods A total of 21 patients with rectal carcinoma treated in our hospital from January 2009 to January 2012 were divided into two groups at random, i. e. median abdominal incision（MAI） group（ n = 12） and lower left abdominal incision （LLAI） group （ n = 9 ）. Results All the cases in both the groups were successfully treated with hand assisted laparoscopic Miles operation. There were no statistical differences in average operation time, intraoperative blood loss, dissected lymph node number, postoperative exhaust defecation time, average hospitalization length and total cost between the MAI group and the LLAI group （ P 〉 0.05 ）. Moreover, there were only two small incisions in the abdomen beside abdominal stoma in the LLAI group. Conclusion During hand assisted laparoscopic Miles operation, MAI is related with smaller trauma and better cosmetic results than LLAI.

关 键 词：手助腹腔镜 经腹会阴直肠癌根治术 切口选择 直肠肿瘤 

分 类 号：R735.37[医药卫生—肿瘤]