摘要
目的探讨手助腹腔镜全系膜切除术((total mesorectal excision,TME)在低位直肠癌手术中的可行性及安全性。方法行手助腹腔镜下全系膜切除术的46例低位直肠癌患者为手助腹腔镜组,行开腹全系膜切除术的53例低位直肠癌患者为开腹组,比较2组术中出血量、手术时间、术后短期并发症发生率、淋巴结清除数量、保肛率等。结果手助腹腔镜组无中转开腹病例;手助腹腔镜组保肛率(91.3%)高于开腹组(73.6%)(P<0.05),手术时间((131±29)min)长于开腹组((109±35)min)(P<0.05),术中出血量、术后短期并发症发生率、住院时间((58±23)mL、21.7%、7.4d)少于开腹组((130±67)mL、27.1%、9.2d)(P<0.05),清扫淋巴结数目((15.3±6.9)个)与开腹组((14.5±5.8)个)比较差异无统计学意义(P>0.05)。结论手助腹腔镜TME治疗低位直肠癌与开腹手术效果相当,可提高术中显露与保肛率,降低术后短期并发症发生率。
Objective To evaluate the feasibility and safety of hand-assisted laparoscopic total mesorectal excision （TME） for low rectal cancer. Methods The blood loss volume, operation lasting time （131 ± 29） minutes, incidence of short-term complications after operation, number of dissected lymph nodes and anus preservation were compared between 46 patients undergoing hand-assisted laparoscopic TME and 53 patients undergoing open TME for low rectal cancer. Results No conversion occurred in hand-assisted laparoscopic group. Hand-assisted laparoscopic group had longer operation lasting time （131±29） minutes, higher anal preservation rate （91.3%）, less blood loss （58±23）mL, lower incidence of postoperative complications （21. 7%） and shorter hospitalization duration （7. 4 days） than that in open surgery group （（109±35） minutes, 73.6%, （130±67） mL,27. 1%, 9.2 days） （P〈0.05）. There was no signficant difference in the number of dissected lymph nodes between two groups （15. 3± 6. 9, 14. 5±5. 8） （P〉0.05）. Conclusions Hand-assisted laparoscopie TME has the similar syrgerieal outcome with open TME, but it can improve anus preservation rate and reduce the incidence of short-term complications after operation.
出处
《中华实用诊断与治疗杂志》
2014年第7期703-704,共2页
Journal of Chinese Practical Diagnosis and Therapy
关键词
低位直肠癌
手助腹腔镜
全直肠系膜切除
Low rectal cancer
hand-assisted laparoscopic surgery
total mesorectal excision
