腹腔镜低位直肠癌保肛手术120例临床分析

Clinical Analysis of 120 Cases of Laparoscopic Anus Preserving Operation for Low Rectal Cancer

目的探讨腹腔镜技术在低位直肠癌保肛手术中的应用价值.方法选取2008年2月至2014年6月在昆明医科大学第二附属医院确诊为低位直肠癌行保肛手术患者240例,所有病例按随机原则分为实验组(腹腔镜组)和对照组(传统开腹组)2组,每组120例患者,分析比较2组术中、术后的情况,术中评价指标包括手术时间、术中出血量;术后评价指标包括肛门恢复排气时间、吻合口出血、吻合口瘘、切口感染.结果实验组术中出血量(98.3±43.6)m L较对照组(286±92)m L少(P<0.05);实验组术后肛门恢复排气时间(2.3±0.7)d较对照组(3.5±0.9)d快(P<0.05);实验组术后吻合口瘘(5例)较对照组(18例)少(P<0.05).结论腹腔镜技术应用于低位直肠癌保肛手术中较传统开腹手术具有术中出血量少、术后胃肠功能快、吻合口瘘发生率低等优点,治疗效果确切,值得临床应用推广.

Objective To evaluate the application value of laparoscopic anus preserving operation. Methods 240 patients with low rectal cancer were randomly divided into two groups according to the method of operation, 120 patients were treated by laparoscopic in experimental group and the other 120 patients were treated by traditional laparotomy in control group. Then we compared the operation time, hemorrhage during operation, the resuming time of bowel function, anastomotic bleeding, anastomotic fistula and incision infection between the two groups . Results In experimental group, the hemorrhage volume （98.3 ± 43.6） mL was less than control group （286 ± 92） rnL （P〈0.05） , the resuming time of bowel function （2.3 ± 0.7） d was shorter than control group （3.5 ±0.9d） （P〈0.05） , the rate of anastomotic leakage was higher in control group （18 cases） than experimenta/group （5 application.