腹腔镜辅助Miles手术临床应用研究

Clinical application of the laparoscopic Miles surgery

[目的]探讨腹腔镜辅助直肠癌M iles手术的可靠性、安全性及有效性。[方法]回顾性分析36例低位直肠癌患者的临床资料。其中,腹腔镜M iles手术16例,同期开腹M iles手术20例。对比分析两组患者的手术时间、术中出血量、淋巴结清扫数量、术后排气时间、住院时间等。[结果]腹腔镜M iles组术中失血量(235.2±81.9)mL、术后排气时间(44.1±7.8)h均少于开腹M iles手术组(428.7±75.6)mL,(82.5±114)h,差异有显著性意义(P<0.05)。腹腔镜M iles组术后住院时间(11.9±4.2)d、淋巴结清扫数量(15.7±8.3)个,与开腹M iles手术组(14.3±6.4)d,(16.2±7.1)个比较,差异无显著性意义(P>0.05)。[结论]腹腔镜辅助M iles手术是可靠、安全、有效的,而且具有手术创伤小、术中出血量少、术后恢复快等优势。

[Objective] To investigate the safety,efficacy and feasibility of laparoscopic Miles operation for the low rectal cancer.[Methods] The clinical data of 36 patients with low rectal cancer were reviewed retrospectively.Sixteen of these patients received laparoscopic Miles operation and 20 received open resection surgery.The clinical data include the hospital stay,operation time,blood loss,cleared lymph nodes and time of the bowel function recovery.[Results] The average blood loss（235.2±81.9）mL in the operation and the gastrointestinal function recovery time（44.1±7.8）h after operation of laparoscopic Miles surgery were less than those（428.7±75.6）mL and（82.5±114） h of the open procedure（P0.05）.But the number of lymph nodes clearance（15.7±8.3） and hospitalization（11.9±4.2） d of laparoscopic Miles surgery had no significant difference from those（16.2±7.1） and（14.3±6.4） d of the open procedure（P0.05）.[Conclusion] Compared with the open procedure,the laparoscopic Miles surgery had less trauma,less blood loss and quicker recovery.So it is safe,efficient and feasible treatment for the low rectal cancer.