直肠癌应用腹腔镜辅助下经肛门手术的效果  

Laparoscopic Assisted Transanal Surgery for Rectal Cancer

作　　者：颜宏锐[1] YAN Hongrui(Department of Gastrointestinal Surgery,People's Hospital of Macheng,Macheng Hubei 438300,China)

机构地区：[1]湖北省麻城市人民医院胃肠外科,湖北麻城438300

出　　处：《中国继续医学教育》2019年第13期111-113,共3页China Continuing Medical Education

摘　　要：目的对比中低位直肠癌应用腹腔镜全直肠系膜切除术与腹腔镜辅助经肛门全直肠系膜切除术的临床疗效。方法将我院2015年6月—2018年1月收治的72例中低位直肠癌患者根据手术方法不同分为A组与B组,每组36例,A组接受腹腔镜全直肠系膜切除术治疗,B组行腹腔镜辅助经肛门全直肠系膜切除术治疗,对两组手术情况及术后并发症情况进行观察。结果 B组手术时间比A组更长,胃肠道恢复时间、下床时间、出院时间均短于A组,术中出血量少于A组(P<0.05);B组保肛率较A组高(P <0.05),两组术后并发症发生率及肠系膜切除完整度差异无统计学意义(P> 0.05)。结论腹腔镜辅助经肛门全直肠系膜切除术治疗中低位直肠癌创伤较小,也能提高保肛率。Objective To investigate the clinical efficacy of laparoscopic total mesorectal excision and laparoscopic assisted transanal total mesorectal excision in middle and low rectal cancer.Methods 72 patients with low and middle rectal cancer admitted to our hospital from June 2015 to January 2018 were divided into group A and group B according to different surgical methods,36 cases in each group.Group A was given laparoscopic total mesorectal excision,and group B was given laparoscopic assisted transanal total mesorectal excision.The surgical indexes and postoperative complications of the two groups were observed.Results The operation time of group B was longer than that of group A.The recovery time of gastrointestinal tract,bed-time and discharge time were significantly shorter than group A,and the intraoperative blood loss was less than group A(P<0.05).The anal sphincter preservation rate was higher in group B than in group A(P<0.05).There were no significant difference in postoperative complication rate and mesenteric resection integrity between the two groups(P>0.05).Conclusion Laparoscopically assisted transanal total mesorectal excision for the treatment of low-grade rectal cancer has less trauma and can also improve the rate of anal sphincter preservation.

关 键 词：中低位直肠癌 腹腔镜 全直肠系膜切除术 保肛 并发症 肠系膜切除完整度 

分 类 号：R735[医药卫生—肿瘤]