摘要
目的通过对比研究全系膜切除术(Total Mesorectal Excision,TME)+保留盆腔自主神经(Pelvic Autonomic Nerve Preservation,PANP)的腹腔镜直肠癌根治术和开腹直肠癌根治术术后患者排尿情况,探讨两种术式对排尿功能的影响。方法通过腔镜TME+PANP直肠癌根治术40例和同期行开腹TME+PANP直肠癌手术40例患者的临床资料并进行回顾性分析。对比研究2组患者术后近、远期排尿功能障碍程度和排尿功能指标(尿管拔除时间、排尿量、尿流率、残尿量)的差异。结果腹腔镜组近期排尿功能障碍发生3例(7.5%),开腹组发生10例(25.0%),2组比较差异有统计学意义(P<0.05)。腹腔镜组远期排尿功能障碍发生2例(5.0%),开腹组发生4例(10.0%),2组比较差异无统计学意义(P>0.05)。腹腔镜组与开腹组术后尿管拔除时间分别为(2.8±0.7)d和(5.0±0.9)d,术后2周查尿动力学检查:两组排尿量分别为(317.2±32.1)ml和(305.4±29.1)ml,尿流率分别为(28.2±3.2)ml/s和(20.1±2.9)ml/s,残尿量分别为(17.5±3.8)ml和(28.9±3.5)ml。以上指标除排尿量外,余差异均有统计学意义(均P<0.05)。术后3月复查尿动力学检查,2组三项指标差异无统计学意义(P>0.05)。结论保留盆腔自主神经的腹腔镜直肠癌根治术(TME+PANP)能保护直肠癌患者术后近期和远期的排尿功能,降低排尿功能障碍发生率。
Objective To study the influence of laparoscopic radical resection of rectal carcinoma with pelvic autonomic nerve preservation on the urinary function of male patients.Methods 80 patients with rectal cancer were divided into laparoscopic TME＋PANP group and traditional open TME＋PANP group.The urinary functions,time of catheterization,voided volume,maximal flow rate,and urinary residual urine volume were compared between the two groups.Results 2 weeks after surgery,significant differences（P0.05） were found between the two groups in urinary dysfunction rate（7.5% vs.25.0%）,urinary catheterization（2.8±0.7 vs.5.0±0.9）d,maximal flow rate（28.2±3.2 vs.20.1±2.9）ml/s, residual urine volume（17.5±3.8 vs.28.9±3.5）ml,except for voided volume（317.2±32.1 vs.305.4±29.1）ml.There were no significant differences in all the data above between the two groups（P0.05） 3 month after surgery.Conclusions The laparoscopic radical resection of rectal carcinoma with pelvic autonomic nerve preservation can protect the urinary function after surgery,and reduce the rate of urinary dysfunction.
出处
《西部医学》
2011年第2期271-273,共3页
Medical Journal of West China
关键词
腹腔镜
直肠癌
盆腔自主神经
排尿功能
Rectal cancer
Laparoscopic surgery
Pelvic autonomic nerve preservation
Urinary function
