摘要
目的探讨改良腹壁无辅助切口完全腹腔镜直肠癌全直肠系膜切除术在直肠癌中的应用效果。方法选取本院2015年1月~2017年12月收治的62例直肠癌患者纳入研究,按手术方式不同分为两组,观察组31例患者采取改良腹壁无辅助切口完全腹腔镜直肠癌全直肠系膜切除术治疗,对照组31例患者采取开腹手术治疗,比较两组患者的手术时间、手术中出血量、肛门排气时间、住院时间和并发症发生率情况,以及随访1年的局部复发率、远端转移率、生存率情况。结果观察组排气时间、住院时间均显著短于对照组,手术中出血量显著少于对照组,差异有统计学意义(P <0.05);观察组并发症发生率12.90%显著低于对照组38.71%,差异有统计学意义(P <0.05);随访1年,两组患者在局部复发率、远端转移率、1年生存率方面比较,差异无统计学意义(P> 0.05)。结论采取改良腹壁无辅助切口完全腹腔镜直肠癌全直肠系膜切除术治疗直肠癌,有利于降低手术中出血量和并发症发生率,在不会提高复发率的基础上,有助于患者术后恢复,具有临床推广价值。
Objective To explore the application effect of improved total laparoscopic and total mesorectal excision without auxiliary incision for rectal carcinoma. Methods Sixty-two patients with rectal carcinoma admitted in our hospital from January 2015 to December 2017 were selected, and they were divided into two groups according to different operative methods.31 cases in the observation group were treated with improved total laparoscopic and total mesorectal excision without auxiliary incision,and 31 cases in the control group were treated with laparotomy.The operation time,bleeding volume,anal exhaust time,hospitalization time and the incidence of complications were compared between the two groups.The local recurrence rate,distal metastasis rate and survival rate were also compared after 1 year follow-up. Results The exhaust time and hospitalization time in the observation group were significantly shorter than the control group,and the volume of bleeding during operation was significantly less than the control group,with statistical significance(P < 0.05);the incidence of complications in the observation group(12.90%)was significantly lower than the control group(38.71%),with statistical significance(P < 0.05).There was no significant difference in local recurrence rate,distal metastasis rate and survival rate between the two groups after 1 year followup(P > 0.05). Conclusion The application of improved total laparoscopic and total mesorectal excision without auxiliary incision for rectal carcinoma is conducive to reduce the bleeding volume and the incidence of complications during the operation,and on the basis of not increasing the recurrence rate,it is conducive to the recovery after operation.It has clinical popularization value.
作者
李旭
李发辉
李金元
邹卫强
LI Xu;LI Fahui;LI Jinyuan;ZOU Weiqiang(Anorectal surgery,Shaoguan First People’s Hospital,Shaoguan 512000,China)
出处
《中国医药科学》
2019年第10期203-205,239,共4页
China Medicine And Pharmacy
关键词
腹腔镜
直肠癌
全直肠系膜切除术
直肠恶性肿瘤
无辅助切口
Laparoscope
Rectal carcinoma
Total mesorectal excision
Malignant tumor of rectum
Without auxiliary incision
