摘要
目的探讨肥胖男性直肠癌患者根治手术中直肠韧带处理方式及临床效果。方法回顾性分析2008年12月至2010年12月间在郑州大学附属肿瘤医院普通外科行直肠癌根治手术的92例肥胖（体质量指数大于25kg／m2）男性直肠癌的临床资料，按直肠癌根治术中直肠周围韧带处理操作方法不同，分为改良组48例（平行推剪技术处理直肠周围韧带）及传统组44例。比较两组手术时间、术中出血量、术中直肠破溃情况、输尿管损伤情况、直肠周围系膜的完整性和盆壁侧切缘的阳性率。结果改良组手术时间为（66．9±9．8）min，明显少于传统组的（125．4±12．2）min（P=O．000）。改良组术中出血量为（160．3±27．2）ml，传统组为（150．5±28．5）ml，差异无统计学意义（P=O．093）。两组术中直肠破溃率分别为0和18．2％（8／44），直肠周围系膜不完整率分别为6．2％（3／48）和22．7％（10／44），盆腔感染率分别为2．1％（1／48）和20．4％（9／44），差异均有统计学意义（均P〈O．05）。两组均无输尿管损伤和侧切缘阳性病例。结论平行推剪直肠周围韧带技术符合全直肠系膜切除原则，操作简捷，安全高效，易于推广。
Objective To investigate the approach and efficacy of dealing the rectal ligament in resection of rectal cancer in obese male patients. Methods A total of 92 patients （BMI〉25 kg/m2） undergoing resection of rectal cancer from December 2008 to December 2010 in Henan Tumor hospital were assigned into 2 groups according to the surgical technique, the modified group （paralleled clipping of rectal ligament, 48 patients） and traditional group （44 patients）. Operative time, intra-operational bleeding, rectal ulceration, ureteral injury, mesorectal integrity, and positive rate of lateral margin of pelvic wall were compared between two groups. Results The operative time was （66.9~99.8） min in modified group, which was significantly shorter than that in traditional group[（125.4＋12.2）min, P= 0.000]. Intra-operative bleeding was （160.3~27.2） ml in modified group and （150.5 ~28.5） ml in traditional group （P=0.093）. Rectal ulceration rated were 0 and 18.2% （8/44）, mesorectal disintegrity rates were 6.2% and 22.7%, pelvic infection rates were 2.1%（1/48） and 20.4（9/44） in modified and traditional groups respectively, whose differences were all significant （all P〈0.05）. No ureteral injury and positive margin were found in both two groups. Conclusion The approach of paralleled clipping of rectal ligament around the rectum meets the principle of TME, which is simple, safe and effective.
出处
《中华胃肠外科杂志》
CAS
CSCD
2013年第4期367-369,共3页
Chinese Journal of Gastrointestinal Surgery
