腹腔镜Miles术59例近远期疗效分析

The analysis of the short-term and long-term outcomes of laparoscopic Miles surgery from 59 cases

目的：分析腹腔镜Miles术的近远期疗效。方法：回顾分析2001年9月至2009年8月为59例患者施行腹腔镜Miles术的临床资料,并随访至少18个月。结果：57例顺利完成手术,2例中转开腹。手术时间平均156.8min,术中出血（含会阴部）平均95.0ml。术后会阴部切口感染2例,尿潴留4例,造口旁疝3例,粘连性肠梗阻2例。随访18-113个月,中位时间56个月,无切口种植,局部复发4例,远处转移8例,死亡11例。3年总生存率和无病生存率分别为88.7%,80.2%,5年生存率和无病生存率分别为70.7%,70.2%。结论：腹腔镜Miles术患者创伤小,出血少,康复快,近远期疗效与开腹手术相当,值得推广应用。

Objective：To evaluate the short-term and long-term outcomes of laparoscopic Miles surgery.Methods：From Sep.2001 to Aug.2009,59 patients with lower rectal cancer underwent laparoscopic Miles surgery.The clinical data was retrospectively reviewed and the patients were followed up for more than 18 months.Results：There was no operative death.2 patients were converted to open surgery.The average operating time was 156.8min and the average blood loss was 95.0ml（including the perineum）.Postoperative complications occurred including perineal wound infection in 2 patients,urinary retention in 4 patients,parastomal hernia in 3 patients and adhesive bowel obstruction in 2 patients.The median follow-up time was 56 months（ranging from 18 to 113 months）.No port-site recurrence but 4 patients had local recurrence and 8 patients had distant metastasis.11 patients were dead.The overall and disease-free survival rates of 5-years were 70.7% and 7.2%.Those of 3-years were 88.7% and 80.2%.Conclusions：The short-term and long-term outcomes of laparoscopic Miles surgery are not inferior to open surgery.