腹腔镜直肠癌根治术保留自主神经的临床研究

Pelvic Autonomic Nerve Preservation in Radical Operation of Rectal Cancer Under Laparoscope

目的探讨腹腔镜直肠癌根治术中保留自主神经的手术安全性和可行性。方法选择2006年1月-2008年6月在我院手术治疗的Duke’sB期和Duke’sC期的中低位直肠癌57例,分别进行保留自主神经的完全腹腔镜下直肠癌根治术和开腹直肠癌根治术,将患者分为腹腔镜组和开腹组。结果腹腔镜组手术时间为(283±42)min,稍长于开腹组,而平均总出血量为(200±37)ml,略少于开腹组;腹腔镜组与开腹组平均检出淋巴结分别为19.7枚和17.5枚,差异无统计学意义;两组术后短期并发症发生率差异无统计学意义。结论腹腔镜直肠癌根治术能够有效地保留自主神经的功能,具有可靠的安全性和可行性,值得在临床推广应用。

Objective To investigate the security and feasibility of pelvic autonomic nerve preservation in radical operation of rectal carcinoma under laparoscopy.Methods Fifty-seven cases diagnosed as rectal cancer in Duke’s stage B or C from January,2006 to June,2008 were arranged into two groups.One group underwent laparoscopic radical surgery and the other received open radical surgery.At the same time,all patients received pelvic autonomic nerve preservation.Results The average operation time of laparoscopic group was 283±42 min,which was longer than that of laparotomy group,but the average hemorrhage volume of laparoscopic group （200±37 ml） was less than that of laparotomy group.The detected lymph nodes of laparoscopic group and laparotomy group were 19.7 and 17.5,respectively,and there was no statistically significant difference between the two groups.No statistically significant difference was found in short-term postoperative complications between the two groups.Conclusion Laparoscopic radical operation with pelvic autonomic nerve preservation for rectal cancer has the same security effects as open radical operation.So it is recommended for wide use in clinics.