腹腔镜低位直肠癌根治术中应用盆腔腹膜关闭技术的疗效研究  

Effect of the application of pelvic peritoneal closure in the treatment of laparoscopic radical rectal cancer(Miles)

作　　者：吴胜文 乔婷婷[1] 马从超 WU Sheng-wen;QIAO Ting-ting;MA Cong-chao(Department of Gastrointestinal Surgery,the Affiliated Jianhu Hospital of Nantong University,Jianhu 224700,China)

机构地区：[1]江苏省南通大学附属建湖医院胃肠外科,江苏建湖224700

出　　处：《中国现代普通外科进展》2021年第2期112-115,共4页Chinese Journal of Current Advances in General Surgery

基　　金：盐城市医学科技发展计划项目(YK2015075)。

摘　　要：目的:探讨盆腔腹膜关闭技术在腹腔镜低位直肠癌根治术应用的疗效。方法:回顾性分析2012年1月至2016年5月我院54例腹腔镜低位直肠癌根治术中行盆底腹膜关闭患者和57例未行盆底腹膜关闭患者的临床资料。结果:盆腔腹膜关闭组与盆腔腹膜未关闭组在手术时间、术中出血量、肛门排气时间、术后进食时间以及盆腔引流管拔除时间等方面差异均无统计学意义(P>0.05)。盆腔腹膜关闭组中8例患者发生短期并发症;6例患者发生中期并发症;14例患者发生远期并发症,均为肠梗阻。盆腔腹膜未关闭组中31例患者发生短期并发症,28例患者发生中期并发症,36例患者发生远期并发症。所有患者均治疗好转。Coxs回归模型分析提示,盆腔腹膜是否关闭是腹腔镜低位直肠癌根治术患者术后生存的独立指标。结论:腹腔镜Miles术中行盆底腹膜关闭安全可行,具有临床实用价值。Objective: To investigate the long-term clinical study of the application of pelvic peritoneal closure in the treatment of laparoscopic radical rectal cancer(Miles). Methods: From January2012 to June 2014, 54 patients with laparoscopic Miles in the hospital underwent pelvic peritoneal closure and 57 patients with laparoscopic Miles who underwent pelvic peritoneal open. The clinical data were summarized. Results: There was no significant difference in operative time, intraoperative blood loss, anal exhaust time, postoperative feeding time and pelvic drainage tube removal time between the pelvic peritoneal closure group and the pelvic peritoneal open group,P >0.05. A total of 8 short-term complications occurred in the pelvic peritoneal closure group, with 6 intermediate complications, 14 long-term complications. 31 cases of short-term complications occurred in the pelvic peritoneal unclosed group, 28 cases of metastatic complications, and 36 cases of long-term complications, all of which improved. Cox’s regression model analysis suggests that the closure of the pelvic peritoneum is an independent indicator of patient survival. Conclusion: Laparoscopic Miles is safe and feasible for pelvic peritoneal closure. It has clinical value.

关 键 词：直肠肿瘤 腹腔镜 盆底关闭技术 

分 类 号：R735.37[医药卫生—肿瘤]