腹腔镜下电凝钩与超声刀用于低位直肠癌根治术的疗效比较

Laparoscopic Hook Cautery vs Ultrasonic Scalpel for Radical Resection of Low Rectal Cancer

为比较电凝钩和超声刀在腹腔镜下低位直肠癌根治术中的疗效，回顾性分析243例（电凝钩组102例，超声刀组141例）腹腔镜下低位直肠癌根治术患者资料，评价超声刀和电凝钩的疗效。评价指标包括手术时间、出血量、因出血中转开腹例数、术后疼痛、给药次数、吻合口漏发生例数等。结果显示，平均手术时间电凝钩组少于超声刀组[（127士40）min vs（155±62）min]（P〈O．01）。平均出血量电凝钩组（84±48）ml，超声刀组（69±36）ml（P〉O．05）。因出血中转开腹例数电凝钩组8例，超声刀组7例（P〉0．05）。平均给止痛药次数电凝钩组（2．7±0．7）次，超声刀组（4．2±1．1）次（P〈0．05）。吻合口漏发生例数电凝钩组4例，超声刀组4例（P〉O．05）。结果表明，腹腔镜下使用电凝钩行低位直肠癌根治术可以缩短手术时间，减少术后疼痛，但是否会增加出血量和因出血中转开腹几率，有待更多样本进一步研究。

This study aimed to compare the clinical efficacies of laparoscopic hook cautery and ultrasonic scalpel in treating low rectal cancer radically. A retrospective study was carried out in 243 cases who had received laparoscopic resection of low rectal cancer for the evaluation of clinical efficacy （102 cases treated with hook cautery and 141 with ultrasonic scalpel）. Evaluation indicators included operative time,volume of bleeding, number of cases converted to an open surgery due to heavy bleeding, postoperative pain, frequency of durg administration and the number of cases with anastomotic leakage,etc. The results showed that the average operative time was shorter in hook cautery group than that in ultrasonic scalpel group [（127~40） rain vs （155~62）min]（ P d0.01）. The average bleeding volume was （84±48）ml and （69!36）ml in hook cautery group and ultrasonic scalpel group,respectively（ P 〉 0.05） . Eight cases were converted to an open surgery due to heavy bleeding during operation in hook cautery group, 7 cases were in ultrasonic scal- pel group（ P 〉0.05 ）. The average number of times of giving painkiller was （2.7±01 7） times and （4.2± 1.1） times in hook cautery group and ultrasonic scalpel group,respectively （ P 〈0.05）four cases devel- oped anastomotic leakage in hook radically cautery group and 4 in ultrasonic scalpel group（ P 〉0.05 ）. It is concluded that laparoscopic cautery hook radically treating low rectal cancer can shorten the operative time, reduce postoperative pain, but whether it will increase the volume of bleeding and the chance of being converted to an open surgery need more samples and further research.