经腹腔镜低位直肠癌根治性切除结肠肛管吻合术的临床应用

Clinical Study of Laparoscopic Low Rectal Cancer Radical Resection and Coloanai Anastomosis .. Methods and Outcome

为探讨经腹腔镜低位直肠癌切除结肠肛管吻合术的效果，回顾性对比研究2001年7月至2006年3月间采用经腹腔镜和经开腹肛管切除结肠肛管吻合术治疗低位直肠癌患者的临床资料，包括病理指标、术后恢复指标、术后并发症和肛门自制功能等。腹腔镜组13例，开腹组12例。结果显示，腹腔镜组无中转手术及手术死亡，4例同时胆囊切除，1例同时全结肠切除后行回肠肛管吻合术。两组术后病理指标、术后并发症发生率及术后肛门功能等无显著性差异，腹腔镜组手术时间、术中估计失血量、术后镇痛、排气时间、下床活动时间及住院天数均明显少于开腹组。结果表明，经腹腔镜低位直肠癌切除结肠肛管吻合术治疗低位直肠癌安全、有效、经济，具有显著的微创优势。

The objective of the study was to investigate the efficacy of laparoscopic abdominal-anal canal radical resection in the treatment of low rectal cancer. The clinical data（from July 2001 to March 2006）,including pathological indexes, postoperative recovery indexes, postoperative complications, anal function continence,etc, were analized retrospectively. Altogether 25 cases were enrolled in the study, 13 in the laparoscopic group and 12 in the open group. As results,there were no conversive and death cases. 4 patients underwent laparoscopic cholecystectomy and one patient underwent hand assisted laparoscopic total colectomy and ileo-anal anastomosis. The postoperative pathology, the occurrence rate of postoperative complications and postoperative anal function in the two groups were similar, while the surgical time, intraoperative blood loss, postoperative pain, intestinal gas dischargeng time, walking and hospital stay in the laparoscopic group were better than that in open group. It is concluded that laparoscopic abdominal-anal canal radical resection in the treatment of low rectal cancer is safe, effective, economic and superior in open operation.