腹腔镜肿瘤特异系膜切除在中低位直肠癌手术中的应用  

Experience of Laparoscopic Tumor-Specific Mesorectal Excision for Middle or Low Rectal Cancer

作　　者：周国强[1] 石志良[1] 郭健[1] 韩复[1] 李雪峰[1] 何宋兵[2] ZHOU Guo-qiang SHI Zhi-liang GUO Jian HAN Fu LI Xue-feng HE Song-bing(Department of Gastrointestinal Surgery, the Second Hospital of Changshu, Changshu, Jiangsu, 215500, China Department of General Surgery, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China)

机构地区：[1]江苏省常熟市第二人民医院普外胃肠科,江苏常熟215500 [2]苏州大学附属第一医院普外科,江苏苏州215006

出　　处：《中国血液流变学杂志》2016年第2期207-209,共3页Chinese Journal of Hemorheology

基　　金：江苏省卫生计生委研究项目（YG201406）,江苏省“六大高峰人才”项目（2015-WSW-014）

摘　　要：目的探讨腹腔镜肿瘤特异系膜切除（L-TSME）手术治疗中低位直肠癌的应用。方法将2014年01月-2016年05月手术的45例中低位直肠癌患者分为L—TSME组（n=20）和TME（全直肠系膜切除）组（n=25），比较两组患者术后吻合口瘘、术后肠功能恢复时间、术后疼痛程度、直肠系膜内淋巴结清除情况等，评价TSME在腹腔镜直肠癌手术中应用的效果。结果L-TSME组与TME组在直肠系膜内淋巴结清除、吻合口瘘发生率方面比较，差异无统计学意义（P〉0．05）；L-TSME组疼痛程度明显低于TME组，差异具有统计学意义（P〈0．05）；L-TSME组术后肠功能恢复时间明显早于TME组，差异具有统计学意义（P〈0．05）。结论L-TSME能够保证直肠癌手术根治性，与传统TME手术比较，L-TSME手术能够减少并发症，促进患者的术后恢复，减少患者的不适反应，L-TSME手术治疗中低位直肠癌值得临床推广应用。Objective To study the feasibility and safety of laparoscopic tumor-specific mesorectal excision （L-TSME） for middle or low rectal cancer. Methods 45 patients with rectal carcinoma between January 2014 and May 2016 in our hospital were selected and divided into total mesorectal excision （TME） group （n--25） and L-TSME group （n=20）. The anastomotic fistula, recovery time of intestinal function, degree of pain and cleaning of lymphnode of mesentery were compared between the two groups. Results The results of L-TSME group showed that cleaning of lymphnode of mesentery and anastomotic fistula were similar to those of TME group （P 〉 0.05）. Compared with TME group, the degree of pain of L-TSME group were lower significantly （P 〈 0.05）. Compared with TME group, the intestinal function of L-TSME group recovery was earlier than the TME group recovery （P 〈 0.05）. Conclusion L-TSME can guarantee the radical excision of rectal cancer, promote postoperative recovery of patients, reduce discomfort and the incidence of complications, and L-TSME is prospective.

关 键 词：腹腔镜外科手术 直肠肿瘤 全系膜切除术 肿瘤特异系膜切除术 

分 类 号：R735.37[医药卫生—肿瘤] R730.56[医药卫生—临床医学]