腹部无切口经肛门外翻切除的腹腔镜下低位直肠癌根治术的疗效分析  

Effect analysis of abdominal low rectal carcinoma radical resection by anal eversion under laparoscope without abdominal incision

作　　者：亓军 周童 刘伟 毕于合 王金申[2] QI Jun;ZHOU Tong;LIU Wei;BI Yu-he;WANG Jin-shen(Department of General Surgery,Jinan People's Hospital,Jinan 271100,China;Department of General Surgery,Shandong Provincial Hospital,Jinan 250031,China)

机构地区：[1]济南市人民医院普外科,山东济南271100 [2]山东省立医院普外科,山东济南250031

出　　处：《中国现代普通外科进展》2020年第7期515-517,522,共4页Chinese Journal of Current Advances in General Surgery

基　　金：山东省重点研发计划项目(2017G006007);济南市科技计划项目(201704128)。

摘　　要：目的:2种腹部无切口经肛门外翻切除标本的腹腔镜下低位直肠癌根治术的效果比较。方法 :选取2016年6月—2018年7月在济南市人民医院诊治的低位直肠癌患者85例进行前瞻性研究,采用随机数字法分为改良组(45例)和常规组(40例),改良组采用抵钉座体外置入法经肛门外翻切除标本的腹腔镜下低位直肠癌根治术,常规组采用常规经肛门外翻切除标本的腹腔镜下低位直肠癌根治术。结果:两组淋巴结清除数量和手术时间相比,差异无统计学意义(P>0.05);与常规组相比,改良组术中出血量、住院时间及胃肠功能恢复时间均显著缩短,差异有统计学意义(P<0.05);与常规组相比,改良组术后24h和48 h的VAS评分均显著降低,差异有统计学意义(P<0.05);改良组发生术后不良反应7例(15.6%),常规组6例(15.0%),两组差异无统计学意义(P>0.05)。结论:抵钉座体外置入法经肛门外翻切除标本的腹腔镜下低位直肠癌根治术临床效果较好,术中出血量较少、术后恢复快,且并发症少。Objective: Comparison of the effect with two kinds of abdominal low rectal carcinoma radical resection by anal eversion under laparoscope without abdominal incision. Methods: 85 cases low rectal carcinoma patients were collected from June 2016 to July 2018 in Jinan people's hospital conducted prospective study, divided by random number into improved group(45 cases) and routine group (40 cases), the improved group was given laparoscopic resection of low rectal cancer with resection of anal eversion by external fixation of the nail holder, the routine group was given routine laparoscopic resection of low rectal cancer with resection of anal eversion. Results: Two groups in terms of the nodal dissection and operation time were compared had no statistically significant(P>0.05);Compared with the routine group, the length of hospital stay, intraoperative blood loss and recovery time of gastrointestinal function of the control group was significantly shortened, the differences were statistically significant(P<0.05);Compared with the routine group, the VAS score after operation for 24 h and 48 h of the improved group was significantly decreased, the differences were statistically significant(P<0.05);The incidence of postoperative adverse reactions of the improved group is 7 cases(15.6%), the incidence of postoperative adverse reactions of the control group was 6 cases (15.0%), the difference was not statistically significant(P>0.05). Conclusion: Laparoscopic resection of low rectal cancer with resection of anal eversion by external fixation of the nail holder has good effect, with less intraoperative blood loss and faster postoperative recovery, and fewer complications.

关 键 词：低位直肠癌 腹腔镜 经肛门外翻 经自然腔道取标本手术 

分 类 号：R735.37[医药卫生—肿瘤]