腹腔镜和开放手术在直肠癌患者腹膜外造口联合盆底腹膜重建中的应用价值  

Application Value of Laparoscopy and Open Surgery in Extraperitoneal Stomy Combined with Pelvic Floor Peritoneal Reconstruction in Patients with Rectal Cancer

作　　者：邹健军 庄晓波 林海欧 ZOU Jianjun;ZHUANG Xiaobo;LIN Haiou(Department of SurgeryⅡ,Jiexi County People′s Hospital,Jieyang,Guangdong Province,515400 China)

机构地区：[1]广东省揭阳市揭西县人民医院外二科,广东揭阳515400

出　　处：《系统医学》2024年第1期133-136,共4页Systems Medicine

摘　　要：目的分析在直肠癌患者腹膜外造口联合盆底腹膜重建中,腹腔镜与开放手术的应用价值。方法选取2021年1月—2022年12月广东省揭阳市揭西县人民医院外二科收治的58例的低位直肠癌患者为研究对象,根据手术方式的不同分为开放组和腹腔镜组,每组29例。开放组以腹会阴联合切除术(Abdominoperineal Resection,APR),腹腔镜组以腹腔镜腹会阴联合切除术(Laparoscopic Abdominoperineal Resection,LAPR)治疗,对比各组中患者的情况。结果腹腔镜组手术时间、住院时间、导尿管拔除时间短于开放组,出血量少于开放组,淋巴结清扫数目多于开放组,差异有统计学意义(P均<0.05)。腹腔镜组会阴部并发症、造口并发症发生率(6.90%、3.45%)低于开放组(27.59%、20.69%),差异有统计学意义(χ^(2)=4.350、4.061,P均<0.05)。结论腹腔镜下腹膜外造口联合盆底腹膜重建对患者造成损伤更小,术中出血量少,住院时间短,切口裂开以及切口感染率低,较开放手术更具有价值。Objective To analyze the value of laparoscopy and open surgery in extraperitoneal stomy combined with pelvic floor peritoneal reconstruction in patients with rectal cancer.Methods 58 patients with low rectal cancer admitted to the Department of Surgery of Jiexi County People′s Hospital in Jieyang City,Guangdong Province from January 2021 to December 2022 were selected as the research subjects.They were divided into an open group and a laparoscopic group based on different surgical methods,with 29 cases in each group.The open group was treated with abdominoperineal resection(APR),while the laparoscopic group was treated with Laparoscopic abdominoperineal resection(LAPR).The condition of patients in each group was compared.Results The operation time,hospital stay and catheter removal time in laparoscopic group were shorter than those in open group,the blood loss was less than that in open group,and the number of lymph nodes dissection was more than that in open group,and the differences were statistically significant(all P<0.05).The incidence of perineal and stomal complications in the laparoscopic group(6.90%,3.45%)was lower than that in the open group(27.59%,20.69%),and the difference was statistically significant(χ^(2)=4.350,4.061,both P<0.05).Conclusion Peritoneal peritoneostomy combined with pelvic floor peritoneal reconstruction has less damage,less intraoperative blood loss,shorter hospital stay,and lower incision split and infection rate,which is more valuable than open surgery.

关 键 词：直肠癌 腹膜外造口 盆底腹膜重建 并发症 

分 类 号：R544[医药卫生—心血管疾病]