腹腔镜直肠癌Dixon手术选择性应用超声刀和电钩的效果评价  

Evaluation of the effect of selective application of ultrasonic knife and electric hook in laparoscopic Dixon surgery for rectal cancer

作　　者：金芳 徐东飞 尚培中 张伟 葛艳丽 李晓英 苗建军 郭伟林 Jin Fang;Xu Dongfei;Shang Peizhong;Zhang Wei;Ge Yanli;Li Xiaoying;MiaoJianjun;Guo Weilin(Department of General Surgery,the 81st Group Army Hospital of PLA,Zhangjiakou Hebei Province 075000,China;Department of Anesthesiology,Shiji Hospital of Huailai,Zhangjiakou Hebei Province 075400,China)

机构地区：[1]陆军第八十一集团军医院普通外科,河北张家口075000 [2]怀来世济医院麻醉科,河北张家口075400

出　　处：《中华普外科手术学杂志(电子版)》2025年第2期142-145,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：张家口市卫生健康和生物医疗专项重点研发计划项目(2221121D)。

摘　　要：目的探讨腹腔镜直肠癌Dixon手术选择性应用超声刀和电钩的临床效果。方法回顾性分析2017年9月至2023年8月接受腹腔镜Dixon手术的直肠癌患者125例,根据手术解剖方式将患者分为两组,观察组65例术中选择性应用超声刀和电钩,对照组60例术中全程应用超声刀,比较两组患者手术相关指标及术后并发症。应用SPSS 22.0处理数据,计量资料采用(±s)表示,行独立样本t检验;计数资料采用[例(%)]表示,行χ^(2)检验。P<0.05为差异有统计学意义。结果观察组与对照组比较,手术时间差异有统计学意义(P<0.05),患者术中失血量、术后3d腹腔引流总量、引流管拔除时间、尿管拔除时间、肠功能恢复时间及术后平均住院日差异无统计学意义(P>0.05)。两组患者术后均未发生吻合口出血、吻合口漏及尿潴留。患者术后1年内吻合口狭窄发生率观察组为3.1%,对照组为3.3%,差异无统计学意义(P>0.05)。结论腹腔镜直肠癌Dixon手术根据解剖部位及组织结构特点选择性应用超声刀和电钩,有利于加速手术进程,减少麻醉时间,降低并发症风险。Objective To investigate the clinical effect of selective application of ultrasonic knife and electric hook in laparoscopic Dixon surgery for rectal cancer.Methods A retrospective analysis was performed on 125 patients with rectal cancer who received laparoscopic Dixon surgery from September 2017 to August 2023.The patients were divided into two groups according to the surgical anatomy method:65 patients in the observation group were selectively treated with ultrasonic knife and electric hook during the operation,and 60 patients in the control group were treated with ultrasonic knife throughout the operation.Operationrelated indicators and postoperative complications were compared between the two groups.SPSS 22.0 was used to process the data.Measurement data were expressed as(x±s)and independent sample t test was performed.The counting data is represented by[cases(%)]and tested by lineχ^(2).P<0.05 was considered statistically significant.Results Compared with the control group,there were statistically significant differences in operation time(P<0.05),but no statistically significant differences in intraoperative blood loss,postoperative 3d abdominal drainage,drainage tube removal time,urinary tube removal time,intestinal function recovery time and postoperative average hospital stay(P>0.05).No postoperative anastomotic hemorrhage,anastomotic leakage and urinary retention occurred in both groups.The incidence of anastomotic stenosis within 1 year after surgery was 3.1%in the observation group and 3.3%in the control group,with no statistical significance(P>0.05).Conclusion Laparoscopic Dixon surgery for rectal cancer selectively uses ultrasonic knife and electric hook according to the anatomical location and tissue structure characteristics,which is conducive to accelerating the surgical process,reducing the anesthesia time,and reducing the risk of complications.

关 键 词：直肠肿瘤 直肠前切除术 全直肠系膜切除术 腹腔镜 超声刀 电钩 

分 类 号：R73[医药卫生—肿瘤]