改良全腹腔镜与腹腔镜辅助直肠癌TME术的对比研究

Comparative study of the modified total laparoscope and laparoscope-assisted total mesorectal excision of rectum cancer

目的分析改良全腹腔镜与腹腔镜辅助直肠癌全直肠系膜切除术的近期疗效。方法分析本院接受手术治疗的直肠癌患者34例,其中16例采用改良全腹腔镜直肠癌全直肠系膜切除术,18例采用传统腹腔镜辅助直肠癌全直肠系膜切除术,比较2组的手术临床指标、保肛率、术后的近期并发症。结果 2组手术时间、术中失血量比较,差异无统计学意义。全腹腔镜组在术后48 h腹腔引流管血量、肛门排气时间、辅助切口长度、术后住院时间、手术耗材费用方面均优于腹腔镜辅助组。结论改良全腹腔镜直肠癌全直肠系膜切除术可达同样的肿瘤根治效果,具有无腹部辅助切口,更加美观、术后肠道恢复快、保肛率高等优点,值得临床推广应用。

Objective To analyze short-term effect of modified total laparoscope and laparoscope-assisted total mesorectal excision（TME） of rectum cancer.Methods Thirty-four rectum cancer patients who underwent surgery in our hospital were included.Among them,16 patients received modified laparoscope TME of rectal cancer,and 18 patients received the traditional laparoscope-assisted TME of rectum cancer.Surgical clinical indicators,anal sphincter preservation rates and short-term complications between the two groups were compared.Results The differences between the length of surgery and intraoperative blood boss in the two groups were not statistically significant.The blood volume from intraperitoneal drainage tube,flatus,auxiliary incision length,postoperative hospital stay and surgical supply costs of the total modified laparoscope group were better than the laparoscope-assisted group Conclusion Modified total laparoscope TME of rectum cancer can equally cure tumor.It has non-assisted incision,and is pleasing to eyes.It has faster postoperative intestinal recovery and higher anal sphincter preservation rate.Thus it is worthy of clinical application.