盆底腹膜重建在3D腹腔镜经腹会阴联合切除术中的应用  

The clinical application value of pelvic peritoneum reconstruction in 3D laparoscopic abdominoperineal resection

作　　者：卢义康 李永胜[1] 洪绍忠 韩孝文 刘洪洲[1] LU Yikang;LI Yongsheng;HONG Shaozhong(Department of Colorectal Surgery, Peace Hospital Affiliated to Changzhi Medical College)

机构地区：[1]长治医学院附属和平医院结直肠外科,046000 [2]长治医学院研究生院

出　　处：《长治医学院学报》2021年第4期283-286,290,共5页Journal of Changzhi Medical College

基　　金：山西省“服务产业创新学科群建设计划”项目(201809)。

摘　　要：目的:评价盆底腹膜重建在3D腹腔镜经腹会阴联合切除术(APR)中的临床应用价值。方法:回顾性分析行3D腹腔镜APR手术的110例低位直肠癌患者临床资料,根据术中是否重建盆底腹膜分为2组。其中在3D腹腔镜APR手术中行盆底腹膜重建72例(重建组),行3D腹腔镜APR手术且未行盆底腹膜重建38例(未重建组)。进行术后随访3~26个月。比较2组手术时间、术中出血量、造口首次排气时间、住院时间、并发症发生情况。结果:2组手术时间、术中出血量、住院时间、并发症发生率比较差异无统计学意义(P>0.05);重建组术后首次肛门排气时间优于未重建组[(3.09±1.50)vs(4.11±2.04)d];未重建组术后有4例患者因小肠坠入盆腔而并发粘连性肠梗阻;无中转开腹手术;术后随访3~26个月,无局部复发和远处转移。结论:是否重建盆底腹膜在3D腹腔镜APR手术术后疗效差异不大,但重建盆底腹膜有利于肠道功能恢复,且可有效预防术后盆腔小肠粘连性肠梗阻发生。Objective:To evaluate the clinical application value of pelvic peritoneal reconstruction in 3D laparoscopic abdominoperineal resection(APR).Methods:A retrospective analysis of the clinical data of 110 patients with low rectal cancer who underwent 3D laparoscopic APR surgery at the Colorectal Surgery Department of Heping Hospital,and divided into two group according to whether the pelvic peritoneum was reconstructed during the operation.Among them,72 cases underwent pelvic peritoneal reconstruction during 3D laparoscopic APR(reconstruction group),38 cases underwent 3D laparoscopic APR without pelvic peritoneal reconstruction(non-reconstruction group).Follow up for 3 to 26 months after surgery,and compare the differences in operation time,intraoperative blood loss,time of first vent from the stoma,hospital stay,and incidence of complications between the two groups.Results:There was no significant difference in general information between the two groups of patients.Compared with the pelvic floor peritoneum reconstruction group,the operation time was longer in the pelvic floor peritoneum reconstruction group,which,but the difference was not statistically significant.There was no statistically significant difference between the two groups in terms of intraoperative blood loss,hospital stay,and total complication rate(P>0.05).The time of first anal exhaust after operation in the reconstruction group was better than that of the non-reconstruction group.Only in the non-reconstruction group,4 cases suffered from adhesive intestinal obstruction due to the small intestine falling into the pelvic cavity.No conversion to open surgery.The patients were followed up for 3~26 months,and there was no local recurrence or distant metastasis.Conclusion:Whether to reconstruct the pelvic peritoneum is not much different after 3D laparoscopic APR surgery,but the reconstruction of the pelvic,It’s good for the recovery of intestinal function peritoneum can effectively prevent the occurrence of postoperative pelvic and small bowel adhesi

关 键 词：盆底腹膜重建 低位直肠癌 3D腹腔镜 经腹会阴联合切除手术 

分 类 号：R735[医药卫生—肿瘤]