摘要
目的探讨肥胖中低位直肠癌患者行腹腔镜全直肠系膜切除手术的安全性、可行性。方法回顾总结该院院胃肠外科2011年1月-2013年12月收治的153例腹腔镜中低位直肠癌手术的患者资料。比较同期105例正常体重组[体重指数(body mass index,BMI)<25.0 kg/m2],40例超重组(25.0 kg/m2≤BMI≤29.9kg/m2),8例肥胖组(BMI≥30.0 kg/m2)一般情况、手术危险程度(ASA)分级、肿瘤大小、肿瘤位置、术前分期、手术指标、术后恢复及术后并发症。结果 3组病例在年龄、性别、肿瘤大小、肿瘤位置、手术危险程度(ASA)分级、术前分期差异均无显著性(P>0.05),3组病例术前合并症差异有显著性(P<0.01)。3组病例手术方式、手术时间、术中出血量、排气时间、进食流质时间及住院时间,差异均无显著性(P>0.05)。正常体重组、超重组和肥胖组中转开腹率分别为5.7%,5%和0%,差异无显著性(P>0.05)。正常体重组、超重组和肥胖组获取淋巴结数分别为15.1、14.6及12.4个,差异无显著性(P>0.05)。正常体重组、超重组和肥胖组术后并发症发生率分别为16.2%、20%及37.5%,差异无显著性(P>0.05)。结论腹腔镜全直肠系膜切除术在肥胖直肠癌患者中应用是安全,可行的。
【Objective】To investigate the safety and feasibility of laparoscopic TME in obese patients with mid and lower rectal cancer.【Methods】A retrospective analysis was conducted among 153 patients who had undergone laparoscopic TME from January 2011 to December 2013. Patients were classified as normal weight（body mass index[BMI]〈25.0 kg/m^2）, overweight（BMI 25.0~29.9 kg/m^2）, and obese（BMI≥30 kg/m^2）. 105 patients, 40 patients and 8patients were classified as normal weight, overweight and obese, respectively. These three groups were compared with each other in terms of demography, American Society of Anesthesiologists（ASA） classification, tumor size, tumor location, preoperative stage distribution, details of operations, post operative recovery, and post operative complica-tions.【Results】No significant differences were found about age, gender, ASA score, tumor size, tumor location, preoperative stage distribution among the three groups（P〉0.05）. The complication of patients was different among the three groups（P〈0.01）. There were no significantly differences among the groups in terms of operative type, average operative time, blood loss, distal margin, time to flatus, time to liquid diet, time to hospital stay（P〉0.05）. There were no significant differences in the conversion rate among the three groups（P〉0.05）, which was 5.7%, 5% and 0% in the normal weight, overweight, and obese groups. There were no significantly differences in the number of lymph node harvested among the three groups（P〉0.05）, which was 15.1, 14.6 and 12.4 in the normal weight, overweight,and obese groups. The proportion of complications between the groups showed no significantly difference（P〉0.05）,which was 16.2%, 20%, 37.5% in the normal weight, overweight, and obese groups. 【Conclusion】Laparoscopic TME in obese patients with mid and lower rectal cancer is safe and feasible.
出处
《中国内镜杂志》
北大核心
2015年第2期127-131,共5页
China Journal of Endoscopy
