改良双吻合技术在腹腔镜直肠前切除术中的应用  

Application of modified double-stapling technique in laparoscopic anterior rectal resection

作　　者：张垒 马俊 王松松 苗同林 肖志强 单长岭 ZHANG Lei;MA Jun;WANG Songsong(Department of Gastrointestinal Surgery,the Affiliated Jinxiang Hospital of Jining Medical College,Jining 272200,China)

机构地区：[1]济宁医学院附属金乡医院胃肠外科,山东济宁272200

出　　处：《腹腔镜外科杂志》2023年第5期344-348,共5页Journal of Laparoscopic Surgery

基　　金：济宁医学院附属金乡医院新技术新项目基金(JY2020012)。

摘　　要：目的:探讨改良双吻合技术在腹腔镜直肠前切除术中的应用效果。方法:回顾分析2018年2月至2022年10月收治的126例行腹腔镜直肠前切除术患者的临床资料。根据吻合方式分为改良双吻合组(观察组,n=61)与传统双吻合组(对照组,n=65)。对比分析两组临床资料、手术时间、术中出血量、术后排气时间、饮食时间及并发症发生率等指标。结果:两组均顺利完成手术,两组患者基线资料差异无统计学意义(P>0.05)。观察组与对照组手术时间[(180.82±40.93)min vs.(176.75±31.66)min]、术中出血量[(75.57±21.31)mL vs.(74.46±21.29)mL]、术后排气时间[(4.52±0.92)d vs.(4.51±1.11)d]、饮食时间[(4.77±1.02)d vs.(4.82±1.68)d]差异无统计学意义(P>0.05)。术后共11例发生吻合口漏,其中观察组2例(3.28%),对照组9例(13.85%),观察组吻合口漏发生率低于对照组,差异有统计学意义(P<0.05)。两组术后吻合口出血、腹腔感染、肠梗阻、切口感染、吻合口狭窄发生率差异无统计学意义(P>0.05)。结论:改良双吻合在腹腔镜直肠前切除术中安全、有效,可降低吻合口漏发生率。Objective:To investigate the effectiveness of modified double-stapling technique in laparoscopic anterior resection for patients with rectal cancer.Methods:Clinical data of one hundred and twenty-six patients who underwent laparoscopic anterior rectal resection from Feb.2018 to Oct.2022 were retrospectively analyzed.Depending on the anastomosis technique,patients were divided into the observation group(n=61)and control group(n=65).The patients in the observation group were treated with the modified doublestapling technique while patients in the control group were treated with traditional double-stapling technique,and the clinical data,operative time,intraoperative blood loss,postoperative exhaust time,postoperative eating time and incidence of complications were compared between the two groups.Results:All the enrolled patients completed surgery successfully.There was no significant difference in basic data between the two groups(P>0.05).The difference was not statistically significant between the observation group and the control group in operative time[(180.82±40.93)min vs.(176.75±31.66)min],intraoperative blood loss[(75.57±21.31)mL vs.(74.46±21.29)mL],postoperative exhaust time[(4.52±0.92)d vs.(4.51±1.11)d]and postoperative eating time[(4.77±1.02)d vs.(4.82±1.68)d](P>0.05).Anastomotic leakage occurred in 11 cases.The incidence of anastomotic leakage was 3.28%(2/61)in the observation group and 13.85%(9/65)in the control group(P<0.05).No significant difference was noted between the 2 groups in postoperative anastomotic bleeding,abdominal infection,ileus,incision infection and anastomotic stenosis(P>0.05).Conclusions:Modified double-stapling technique in laparoscopic anterior rectal resection is safe and effective,and can reduce the incidence of anastomotic leakage.

关 键 词：直肠肿瘤 腹腔镜检查 双吻合技术 吻合口漏 

分 类 号：R735.37[医药卫生—肿瘤]