腹腔镜辅助下直肠外翻拖出式手术治疗直肠癌的临床研究

Study on the clinical effects of laparoscopic assisted rectal eversion pull-through operation for rectal cancer

目的探讨腹腔镜辅助下直肠外翻拖出式手术治疗直肠癌的疗效与安全性。方法选取2008年12月至2012年6月间接受腹腔镜辅助下直肠外翻拖出式手术的40位直肠癌患者作为研究组，同时抽取同期接受腹腔镜辅助下直肠前切除直肠癌根治术的40例患者作为对照组。回顾性分析两组手术的并发症、术后肛门功能和短期局部复发率的情况。结果两组患者各有1例出现吻合口漏，对照组患者有1例吻合口出血，无手术死亡病例。随访6个月～2年，研究组患者有1例复发，对照组患者有2例复发。两组患者肛门均保存了控制排便功能，研究组患者在恢复进食2周后每天排便次数多于对照组（P=0．025）。结论腹腔镜辅助下直肠外翻拖出式手术操作简洁方便、安全可靠、疗效明显，提高了患者的生活质量，值得推广运用。

Objective To evaluate the safety and efficacy of laparoscopic assisted rectal eversion out clinical operation. Methods 40 patients receiving the operation in our hospital from 2008 December to 2012 June were selected as study group, and 40 patients receiving laparoscopic assisted rectal anterior resec- tion for rectal cancer as control group. The postoperative complications, the anal function and local recurrence of short-term rate of the two groups were retrospectively analyzed. Results There was one case of anasto- motic leakage occurrence respectively in two groups, and one case of anastomotic hemorrhage in the control group. No operation death was observated. Resuhs of follow-up for half a year to two years showwed that there was 1 case of recurrence in study group and 2 cases in the control group, the two groups kept control of anus bowel function, and daily defecation times of the study group after recovery of eating two weeks later was higher than that of control group （ P = 0. 025 ）. Conclusions Laparoscopic assisted rectal eversion pull- through operation is simple and convenient, safe and reliable, obviously effective, which improve the quality of life of patients and is worthy of further application.