腹腔镜与开腹改良直肠前切除术治疗成人重度直肠脱垂的对比研究  

Comparative study of modified laparoscopic and open anterior resection of rectum for serious rectal prolapse in adult patients

作　　者：贾如江[1] 尹清臣[1] 侯丽艳[1] 张利宾[1] JIA Ru-jiang YIN Qing-chen HOU Li-yan et al.(Department of General Surgery, Central Hospital of Handan, Handan 056001, China)

机构地区：[1]邯郸市中心医院,河北邯郸056001

出　　处：《腹腔镜外科杂志》2016年第11期842-845,共4页Journal of Laparoscopic Surgery

摘　　要：目的：对比分析腹腔镜与开腹改良直肠前切除术治疗成人重度直肠脱垂的临床疗效及安全性。方法：回顾分析2009~2015年采用腹腔镜改良直肠前切除术治疗的30例成人重度直肠脱垂患者的临床资料,并与同期开腹手术治疗的30例患者进行对比分析。结果：两组手术均获成功,手术切除标本长度平均（24.2±4.0）cm与（23.6±4.4）cm,两组相比差异无统计学意义。术中出血量平均（85.5±24.1）ml与（181.7±44.2）ml,肠道功能恢复时间平均（2.3±1.8）d与（4.2±1.5）d,术后平均住院（7.7±1.1）d与（11.4±1.8）d,手术时间平均（170.0±11.8）min与（120.9±20.3）min,两组相比差异有统计学意义。并发症发生率分别为16.7%与46.7%,腔镜组术后并发症发生率低,两组相比差异有统计学意义。术后平均随访（36.0±11.3）个月,两组复发率差异无统计学意义。结论：腹腔镜改良直肠前切除术治疗成人重度直肠脱垂安全、可靠,可取得与开腹手术相同的效果,复发率低,具有明显的微创优势,术后康复快,临床疗效较满意。Objective： To investigate the clinical effect and safety of modified laparoscopic and open anterior resection of rectum for serious rectal prolapse in adult patients. Methods： The retrospective analysis was made on the clinical data of 30 adult patients who suffered from serious rectal prolapse and underwent modified laparoscopic anterior resection of rectum（ laparoscopic group） and 30 adult patients who underwent laparotomy（ open group） from 2009 to 2015. Results： Surgery was successful in all of the 60 cases. The mean length of the resected specimen was（ 24. 2 ± 4. 0） cm vs.（ 23. 6 ± 4. 4） cm and they showed no statistically significant difference between the two groups. There were statistically significant differences in terms of mean blood loss during the operation [（ 85. 5 ±24. 1） ml vs.（ 181. 7 ± 44. 2） ml],the recovery time of intestinal function [（ 2. 3 ± 1. 8） d vs.（ 4. 2 ± 1. 5） d],the mean postoperative length of hospital stay [（ 7. 7 ± 1. 1） d vs.（ 11. 4 ± 1. 8） d] and the mean operative time [（ 170. 0 ± 11. 8） min vs.（ 120. 9 ±20. 3） min] between the two groups. There was statistically significant difference between the two groups in the rate of complications（ 16. 7% vs. 46. 7%）. All the patients were followed up for（ 36. 0 ± 11. 3） months and the recurrence was not significantly different between the two groups. Conclusions： The modified laparoscopic anterior resection of rectum for serious rectal prolapse in adult patients is safe,reliable,has similar effect with laparotomy,obvious advantages of minimal invasion,low recurrence rate,quick postoperative recovery and satisfying clinical effect.

关 键 词：直肠脱垂 改良直肠前切除术 腹腔镜检查 剖腹术 对比研究 

分 类 号：R657.19[医药卫生—外科学]