腹腔镜低位直肠癌根治会阴人工肛门重建术的疗效分析  

Clinical effect of laparoscopic Mile's and perineal anal reconstruction operation for patients with low rectal cancer:A retrospective analysis

作　　者：魏东[1] 张辉[1] 蔡建[1] 赵艇[1] 张远耀[1] 

机构地区：[1]解放军150医院肛肠外科研究所,河南洛阳471031

出　　处：《实用医药杂志》2015年第1期11-14,共4页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨腹腔镜低位直肠癌全系膜切除会阴人工肛门重建术的安全性和临床疗效。方法分析2006年4月—2010年2月解放军第150中心医院全军肛肠外科研究所收治的102例采用低位直肠癌根治会阴人工肛门重建术的患者,其中腹腔镜手术58例,开腹手术44例。观察指标包括平均手术时间、手术中平均出血量、淋巴清扫数目、肛门排气时间、住院时间、术后并发症等;采用Kaplan-Meier法计算生存率,t检验和χ2检验分析数据。结果腹腔镜组的术中平均出血量为88.28 ml低于开腹组247.73 ml(P<0.01);腹腔镜组术后肛门恢复排气时间、恢复流质饮食时间、平均住院时间均明显短于开腹组(P<0.01),腹腔镜组检出的淋巴结为18.93个多于开腹组的13.09个(P<0.01);两组平均手术时间和术后常见并发症比较,差异无统计学意义(P>0.05)。截至2010年02月,腹腔镜组3年累计生存率为87.9%与开腹组86.1%比较差异无统计学意义(P>0.05)。结论腹腔镜低位直肠癌根治会阴人工肛门重建术手术与开腹直肠癌手术有同样的疗效,且创伤小、术后恢复快、安全可行。Objective To evaluate the safety and clinical effect of laparoscopic Mile＇s and perineal anal reconstruction operation for patients with low rectal cancer. Methods All of the patients underwent Mile＇s and perineal anal reconstruction operation for rectal cancer in No. 150 hospital from April 2006 to February 2010 were followed up. Among them 58 patients underwent laparoscopiesurgery,44 patients underwent open surgery. All these datas such as sur^ival time,operation time,blood loss, harvested lymph nodes,the time to first flatus,the time of stay in hospital and complications were collected and compared between the two groups. Results The average blood loss in laparoscopic and open group were 88.28 and 247.73 ml respectively （P〈0.01）. The time of first flatus,first drink and hospital stay were shorter in laparoscopie group than in open group（P〈0.01）. The number of lymph nodes harvested in laparoscopic group were significant larger than the number in open group （18.931±6.973 and 13.091±8.166,P〈0.01）o There were no significant difference in operation time and complication morbidity in two groups （P〉0.05）. The 3 years accumulated survival rates were 87.9% and 86.1% in laparoscopic and open group respectively with no significant difference （P〉0.05）. Conclusion The clinical effects of laparoscopic and open Mile＇s and perineal anal reconstruction operation were similar for patients with low rectal cancer. Laparoscopic opereLtion is a safe and feasible choice with quicker recover after the operation.

关 键 词：直肠癌 腹腔镜检查 会阴人工肛门重建术 

分 类 号：R657.1[医药卫生—外科学]