腹腔镜低位直肠癌Miles手术中关闭盆底腹膜结合骶前引流的效果观察  

The clinical efficacy of closure of pelvic floor peritoneum combined with anterior sacral drainage in Miles laparoscopic surgery for low rectal cancer

作　　者：骆永富 LUO Yong-fu(Gastrointestinal Surgery Dept.,Yongzhou Municipal Central Hospital,Yongzhou,Hunan 421001,China)

机构地区：[1]永州市中心医院胃肠外科

出　　处：《实用医药杂志》2020年第1期6-9,13,共5页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨关闭盆底腹膜结合骶前引流在腹腔镜低位直肠癌Miles手术的临床应用价值。方法回顾性分析2015年6月—2017年6月笔者所在医院胃肠外科接受腹腔镜低位直肠癌Miles手术切除的96例临床资料。以是否关闭盆底腹膜分为两组各48例。结果两组患者的年龄、手术时间、手术出血量、术后住院时间、术后骶前感染、术后肿瘤复发比较显示差异均无统计学意义(P>0.05),而两组在性别、肿瘤分期、术后肠梗阻、放射性肠炎方面比较,显示有显著性差异(P<0.05)。结论关闭盆底腹膜联合骶前引流可以明显减少腹腔镜直肠癌Miles手术的术后肠梗阻和放射性肠炎的发生,但是对于女性且子宫未切除、肿瘤pTNM临床分期晚者,可考虑放弃关闭盆底腹膜。Objective To investigate the clinical application value of Miles laparoscopic surgery for low rectal cancer with closure of pelvic floor peritoneum combined with anterior sacral drainage.Methods A retrospective study of 96 patients with low rectal cancer who received the Miles of laparoscopic resection in gastrointestinal surgery department of Yongzhou central hospital of hunan province from June 2015 to June 2017 who were divided into two groups according to with or without to close pelvic floor peritoneum,48 case for each.Results there were no statistically significant differences between the two groups in age,operative time,surgically bleeding volume,postoperative hospitalization time,postoperative pre-sacral infection and postoperative tumor recurrence(P>0.05),while there were statistically significant differences in gender,tumor stage,postoperative intestinal obstruction and radiation enteritis(P<0.05).Conclusion The closure of pelvic floor peritoneum combined with anterior sacral drainage which can significantly reduce the incidence of postoperative intestinal obstruction and radioactive enteritis after Miles surgery for laparoscopic rectal cancer.However,for the patients'clinical tumor pTNM stage being late,or for female patients with unresected uterus,it should be to consider to give up closure of pelvic floor peritoneum.

关 键 词：关闭盆底腹膜 骶前引流 低位直肠癌 

分 类 号：R735.37[医药卫生—肿瘤]