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腹腔镜下全直肠系膜切除治疗低位直肠癌的体会 被引量:4

Experience in the laparoscopic total mesorectal excision for treating low rectal cancer
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摘要 目的总结腹腔镜下全直肠系膜切除治疗低位直肠癌的手术体会。方法选择我院2007年3月至2012年6月收治的低位直肠癌患者,根据手术方法不同,选择腹腔镜下全直肠系膜切除术50例(腹腔镜组)和开腹下实施直肠癌全直肠系膜切除术50例(开腹组),对两组病人术中出血量、手术时间、术后肛门排气时间、住院时间、切除淋巴结总数、住院总费用、随访结果等资料进行对比及临床分析。结果腹腔镜组术中出血量、手术时间、术后肛门排气时间、住院时间均较开腹组少(P均<0.05);术中淋巴结清扫、直肠远切端距癌灶最下缘距离与开腹组没有明显差异(P>0.05);腔镜组的术后并发症及术后复发均较开腹组少(P<0.05)。结论腹腔镜下全直肠系膜切除治疗低位直肠癌与开腹组相比,腹腔镜组在减少损伤及术后恢复方面优于开腹组。而且腹腹镜组术后复发率低于开腹组。 Objective To summarize the experience in laparoscopic total mesorectal excision (LTME) for the treatment of low rectal cancer. Methods From March 2007 to June 2012, 100 cases with low rectal cancer were analyzed retrospectively. These patients were randomly divided into laparoscopie group and laparotomy group. Among them, 50 cases underwent LTME, and 50 cases underwent laparotomy total mesorectal excision. The intraoperative blood loss, operation time, postoperative passing flatus time, postoperative hospitalization time, dissected number of lymph nodes total hospitalization cost and follow-up results were compared between two groups. Results In the intraoperative blood loss, operation time, postoperative passing flatus time, postoperative hospitalization time, the laparoscopic group was less than that laparotomy group (P〈0.05). In the dissected number of lymph nodes, the total hospitalization cost and the distance from tumor's low margin to distal rectum excising end, there were no difference between two groups. In the postoperative complications and postoperative recurrence the laparoscopic group was lower than that laparotomy group (P〈0.05). Conclusion Compared with the laparoscopic total mesorectal excision group and open total mesorectal excision group for the treatment of low rectal cancer, the long-term curative effects are similar between two groups. But, the former group is better than that the latter group in the reducing injury and promoting postoperative recovery of patients.
出处 《岭南现代临床外科》 2014年第1期99-102,共4页 Lingnan Modern Clinics in Surgery
关键词 腹腔镜手术 全解肠系膜切除术 低位直肠癌 Laparoscopic surgery Total mesorectal excision Low rectal cancer
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