腹腔镜中低位直肠癌根治术保留盆自主神经的疗效分析

Effect of laparoscopy pelvic autonomic nerve preservation in low rectal cancer

目的:探讨腹腔镜中低位直肠癌根治术经"Holy plane"间隙保留盆自主神经的疗效。方法:把实施了经"Holy plane"间隙保留盆自主神经中低位直肠癌根治术的69例老年男性患者分为两组。观察组采用腹腔镜手术,对照组采用常规开腹手术。两组均采用全直肠系膜切除术(total mesorectal excision,TME)。对两组患者的手术时间,术中出血量、术后排尿功能、性功能,局部复发率及5年生存率进行回顾性总结和比较。结果:观察组手术时间明显延长,术中出血量明显少于对照组,两组患者术后排尿功能及性功能障碍的比较均无显著性差异,术后3年患者局部复发率及5年生存率比较无显著性差异。结论:腹腔镜经"Holy plane"间隙保留盆自主神经的中低位直肠癌根治术具有微创优势。在神经保护方面,可以达到与开腹手术相近的手术效果。二者在局部复发率及5年生存率上无明显差异。

Objective： Study the effect of laparoscopy pelvic autonomic nerve preservation in low rectal cancer treated by ＂ Holy plane＂ clearance. Methods： All 69 elderly male patient treated with TME by surgery were divided into two groups（ laparoscopy group,laparotomy group）. To analyze time of operation,intraoperative blood loss,urinary and sexual function,the postoperational local recurrence rate and 5-year survival rate. Results： The time of operation in the study group was significantly longer than that of the control group,and the intraoperative blood loss was less. In urinary and sexual function,the postoperational local recurrence rate and 5-year survival rate between two groups were not significant different. Conclusion： Laparoscopy pelvic autonomic nerve preservation in low rectal cancer treated by ＂ Holy plane＂ clearance is a minimally invasive technique,which has the same effect with laparotomy group.The postoperational local recurrence rate and 5-year survival rate between two groups has no significant difference.