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)&...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。展开更多
Background and goals Sexual dysfunction is a well-documented complication of rectal cancer surgery, with a reported incidence of 18% - 59%. The objective of this study is to evaluate the incidence of sexual dysfunctio...Background and goals Sexual dysfunction is a well-documented complication of rectal cancer surgery, with a reported incidence of 18% - 59%. The objective of this study is to evaluate the incidence of sexual dysfunction (SD) in males after radical resection for rectal cancer and to compare the outcome of open versus laparoscopic rectal resection for different age groups. Patients and methods This prospective randomized study assessed outcomes in male patients that underwent rectal resection for rectal cancer from January 2012 until March 2015 at two large tertiary hospitals in Cairo, Egypt. The patients were randomly allocated into two groups (laparoscopic and open technique) of 40 patients each using the odd number policy for patient allocation. Patients included in each group were further subdivided into two groups according to the type of rectal resection either anterior resection (AR) or abdominoperineal resection (APR). Erectile function was evaluated preoperatively and postoperatively at 3 and 6 months using the International Index of Erectile Function (IIEF) questionnaire. Results There was no significant difference between the laparoscopic and open total mesorectal excision (TME) groups when comparing IIEF score preoperatively. At 3 months postoperatively, the laparoscopic arm showed better results over the open arm (abnormal IIEF in 57.5% vs. 67.5%). The study demonstrated dramatic improvement in SD in both groups at 6 months postoperatively (abnormal IIEF score of 40% in the laparoscopic vs. 42.5% in the open arm) with no significant difference in IIEF score between the two groups (p-value 0.876). At 3 and 6 months postoperatively, younger patients showed significant improvement in SD compared to older patients in both groups with more significant improvement in the laparoscopic group (16.7% vs. 40%). Patients with APR show more SD compared with AR patients whether laparoscopic or open as seen by the abnormal IIEF scores for the the two groups [the laparoscopic group APR patients showed 62.5% abnormal II展开更多
文摘Background and goals Sexual dysfunction is a well-documented complication of rectal cancer surgery, with a reported incidence of 18% - 59%. The objective of this study is to evaluate the incidence of sexual dysfunction (SD) in males after radical resection for rectal cancer and to compare the outcome of open versus laparoscopic rectal resection for different age groups. Patients and methods This prospective randomized study assessed outcomes in male patients that underwent rectal resection for rectal cancer from January 2012 until March 2015 at two large tertiary hospitals in Cairo, Egypt. The patients were randomly allocated into two groups (laparoscopic and open technique) of 40 patients each using the odd number policy for patient allocation. Patients included in each group were further subdivided into two groups according to the type of rectal resection either anterior resection (AR) or abdominoperineal resection (APR). Erectile function was evaluated preoperatively and postoperatively at 3 and 6 months using the International Index of Erectile Function (IIEF) questionnaire. Results There was no significant difference between the laparoscopic and open total mesorectal excision (TME) groups when comparing IIEF score preoperatively. At 3 months postoperatively, the laparoscopic arm showed better results over the open arm (abnormal IIEF in 57.5% vs. 67.5%). The study demonstrated dramatic improvement in SD in both groups at 6 months postoperatively (abnormal IIEF score of 40% in the laparoscopic vs. 42.5% in the open arm) with no significant difference in IIEF score between the two groups (p-value 0.876). At 3 and 6 months postoperatively, younger patients showed significant improvement in SD compared to older patients in both groups with more significant improvement in the laparoscopic group (16.7% vs. 40%). Patients with APR show more SD compared with AR patients whether laparoscopic or open as seen by the abnormal IIEF scores for the the two groups [the laparoscopic group APR patients showed 62.5% abnormal II
