关闭盆底腹膜在腹腔镜直肠癌Miles根治术中的意义

Significance of Close Pelvic Peritoneum in Laparoscope Miles Radical Operation for Rectal Cancer

目的:探究关闭盆底腹膜在腹腔镜直肠癌Miles根治术中的意义。方法:选取2012年3月至2014年3月我院治疗的拟行腹腔镜直肠癌Miles根治术患者48例,按随机数字法分为观察组和对照组各24例,观察组在腹腔镜Miles根治术后关闭盆底腹膜,而对照组则不关闭。比较两组手术时间、骶前引流总量、切口感染率及肠梗阻发生率。结果:观察组的手术时间较对照组长(t=5.207,P=0.000),但两组的骶前引流总量、切口感染率和肠梗阻发生率差异无统计学意义(P=0.210、1.000、0.602)。观察组术后分别有3例(12.50%),对照组有2例(8.33%)患者因肿瘤复发而采取放射治疗,其中仅对照组2例患者出现放射性小肠炎。结论:是否关闭盆底腹膜在腹腔镜直肠癌Miles根治术术后疗效差异不大,但关闭盆底腹膜可有效预防术后放射性治疗中放射性小肠炎的发生。

Objective： To explore significance of significance of close pelvic peritoneum in laparoscope Miles radical operation for rectal cancer. Methods： Selected 48 cases of patients with rectal cancer who wanted to take aparoscope Miles radical operation in our hospital from March 2012 to March 2014, which were divided into observation group and control group by random number method, 24 cases in each group. Patients of observation group took close pelvic peritoneum in laparoscope Miles radical operation while the control group didn＇t. The operation time, amount of presacral drainage, incision infection rate and incidence of intestinal obstruction were compared between two groups. Results： The operation time of observation group was longer than the control group （t=5.207, P=0.000）, while the amount of presacral drainage, incision infection rate and incidence of intestinal obstruction had no statistical significance （P=0.210, 1.000, 0.602）. There were 2 （12.50%） in observation group and 3 （8.33%） in control group who taken radiotherapy for tumor recurrence after operation, 2 case of patients in the control group got radiation enteritis at last. Conclusions： Do close pelvic peritoneum or not has no difference with the effect of laparoscope Miles radical operation for rectal cancer, but close pelvic peritoneum can effectively prevent radioactive enteritis in postoperative radiation therapy