腹腔镜下经肛拖出直肠癌根治术超低位保肛的临床可行性、安全性及疗效评价  

The clinical feasibility,security and efficacy research of laparoscopic transanal pull-through with anal sphincter preservation in the treatment of ultra-low rectal cancer

作　　者：陈少逸[1] 郑邦瑞[1] 陈立言[1] 杨少华[1] 黄辉宏 

机构地区：[1]汕头大学医学院第二附属医院普外科,广东汕头515041

出　　处：《结直肠肛门外科》2015年第2期133-136,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的研究腹腔镜下经肛拖出直肠癌根治术超低位保肛的临床可行性、安全性及疗效。方法将128例直肠癌患者随机分入观察组和对照组,观察组患者于腹腔镜下行经肛拖出直肠癌根治术,对照组患者行常规外科根治术,两组患者护理方法相同,比较两组患者的治疗效果差异。结果观察组患者平均手术时间(138±21)min,进食时间(34±12)h,住院天数(12.0±2.4)d,术中出血(109±49)mL,切口长度(2.9±0.1)cm,止痛时间(1.9±0.4)d,肠道功能恢复时间(2.4±0.4)d,对照组患者平均手术时间(114±22)min,进食时间(68±9)h,住院天数(15.1±3.5)d,术中出血(228±163)mL,切口长度(13.0±2.1)cm,止痛时间(3.8±1.3)d,肠道功能恢复时间(3.9±0.8)d。两组患者术后在排便功能上也存在显著差异,具有统计学意义,P<0.05。结论腹腔镜下经肛拖出直肠癌根治术超低位保肛的临床可行性、安全性及疗效评价均优于常规疗法,值得推广。Objective To investigate the clinical feasibility,security and efficacy research of laparoscopic transanal pull-through with anal sphincter preservation in the treatment of ultra-low rectal cancer.Methods128ultra-low rectal cancer patients were divided into two groups.Patients of observation group were treated with aparoscopic transanal pull-through with anal sphincter preservation.Patients of control group were treated with routine surgical radical prostatectomy.Both of them accepted the same radio therapy.Compare the curative effect of two methods of nursing care.Results The levels of HR,DBP and SBP in the treatment group at each time point had no significant difference,while the levels of HR,DBP and SBP in the control group when skin incision and extubation were obviously higher than that when patients arrived at operation room.The levels of HR,DBP,SBP and BIS during skin incision and extubation in the treatment group were obviously lower than that in the control group,and the extubation time was also shorter.The incidences of dysphoria in revival period and postoperative pain in the treatment group were obviously lower than that in the control group.Conclusion Laparoscopic transanal pull-through with anal sphincter preservation has perfect clinical feasibility,security and efficacy in the treatment of ultra-low rectal cancer.

关 键 词：腹腔镜 直肠癌 临床疗效 

分 类 号：R735.37[医药卫生—肿瘤]