腹腔镜辅助电凝钩法直肠癌根治术的疗效分析  

Clinical effects of laparoscopic electrocoagulating hook＇ method in treatment of rectal cancer

作　　者：秦诚[1] 陈延林[1] 苏庆[1] 黄海旺[1] 

机构地区：[1]广西壮族自治区第二人民医院胃肠外科,桂林541002

出　　处：《中华消化外科杂志》2016年第8期789-794,共6页Chinese Journal of Digestive Surgery

基　　金：广西壮族自治区卫生厅计划课题（Z2010472）

摘　　要：目的探讨腹腔镜辅助电凝钩法直肠癌根治术的临床疗效。方法采用回顾性队列研究方法。收集2004年6月至2009年6月广西壮族自治区第二人民医院收治的237例直肠癌患者的临床资料。237例患者均行直肠癌根治术，其中120例患者行腹腔镜辅助电凝钩直肠癌根治术设为电凝钩组；117例患者行腹腔镜超声刀直肠癌根治术设为超声刀组。观察指标：（1）治疗情况：手术时间、术中出血量、淋巴结清扫数目、术后肛门排气时间、术后下床活动时间、术后住院时间、治疗费用以及术后并发症情况如术后吻合口瘘、肠梗阻、术后排尿困难、性功能障碍情况。（2）随访情况。采用门诊或电话方式随访，随访内容为肿瘤复发、转移情况，如怀疑肿瘤局部或远处复发者行肠镜、胸部X线片、腹部CT等检查证实。随访时间截至2014年12月18日。正态分布的计量资料以面±s表示，组间比较采用t检验；计数资料比较采用，或Fisher确切概率法检验；Kaplan—Meier绘制生存曲线，Log—Rank检验进行生存分析。结果（1）治疗情况：两组患者均顺利完成腹腔镜手术，无中转开腹患者。电凝钩组和超声刀组患者手术时间分别为（156±33）rain和（175±21）min，两组比较，差异无统计学意义（t=25．324，P〉0．05）；术中出血量分别为（116±12）mL和（149±25）mL，两组比较，差异有统计学意义（t=212．740，P〈0．05）；淋巴结清扫数目分别为（18±2）枚和（16±4）枚，两组比较，差异无统计学意义（t=20．117，P〉0．05）。电凝钩组和超声刀组患者术后肛门排气时间、术后下床活动时间、术后住院时间分别为（1．5±0．6）d和（1．6±0．5）d、（1．5±0．5）d和（1．4±0．5）d、（7．5±2．5）d和（8．0±1．8）d，两组上述指标比较，差异均无统计学意义（t=21．477，1．617，1．770，P〉0．05）。治疗费�Objective To explore the clinical effect of laparoscopic electrocoagulating hook＇ method in treatment of rectal cancer. Methods The retrospective cohort study was adopted. The clinical data of 237 patients with rectal cancer who were admitted to the Second People＇s Hospital of Guangxi Zhuang Autonomous Region from June 2004 to June 2009 were collected. Among 237 patients undergoing radical resection of rectal cancer, 120 using laparoseopic eleetrocoagulating hook＇ method were allocated into the laparoscopic electrocoagulating hook＇ group and 117 using laparoscopic ultrasound knife＇s method were allocated into the laparoscopic ultrasound knife＇s group. Observation indicators included ： （ 1 ） treatment situations ： operation time, volume of intraoperative blood loss, number of lymph node dissected, time to anal exsufllation, time for out-of-bed activity, duration of hospital stay, treatment expenses and occurrence of complications （anastomotic leakage, intestinal obstruction, postoperative dysuresia and sexual dysfunction） , （2） follow-up situations. Follow-up using outpatient examination and telephone interview was performed to detect tumor recurrence and metastasis up to December lg, 2014. The colonoscopy, chest X-ray and abdominal computed tomography （CT） were applied to suspected patients with local or distal tumor recurrence. Measurement data with normal distribution were represented asx ± s and comparison between groups was analyzed using t test. Count data were analyzed using chi-square test or Fisher exact probability. The survival curve was drawn by Kaplan-Meier method, and the survival rate was analyzed using the Log-rank test. Results （1） Treatment situations： all the patients underwent successful laparoscopic surgery, without conversion to open surgery. Operation time, number of lymph node dissected, time to anal exsufflation, time for out-of-bed activity and duration of hospital stay were respectively （ 156 ± 33） minutes, 18 ± 2, （ 1.5 ± 0.6） days, （

关 键 词：直肠肿瘤 电凝钩法 腹腔镜检查 

分 类 号：R735.37[医药卫生—肿瘤]