腹腔镜下直肠癌根治术下腹部辅助切口的选择

Selection of Lower Abdominal Assisted Incision in Laparoscopic Radical Resection of Rectal Cancer

目的探讨腹腔镜下直肠癌根治术下腹部辅助不同切口的优劣势,并观察行不同切口对患者术后预后的影响。方法选择我院普外科收治的直肠癌患者92例,两组患者均给予腹腔镜手术治疗,根据采取不同辅助切口的方式分为观察组与对照组,其中45例患者采用耻骨上横切口,列为观察组,47例患者采用腹部纵切口,列为对照组。比较两组患者围手术期手术相关指标水平及术后并发症发生情况的差异。结果两组患者手术时间、术中出血量、术后肠道功能恢复时间及住院时间比较,差异无统计学意义(P>0.05);观察组术后肠道功能恢复时间及住院时间均短于对照组,观察组术后24 h、48 h疼痛VAS评分低于对照组,术后并发症发生率亦低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜下直肠癌根治术下腹部辅助横向切口可减轻患者术后疼痛程度,且可降低相应并发症的发生率。

Objective To explore the advantages and disadvantages of different incisions in lower abdomen of laparoscopic radical resection of rectal cancer,and to observe the effect of different incisions on postoperative prognosis.Methods 92 patients with rectal cancer admitted to general surgery department were selected.Both groups were given laparoscopic surgery.According to the method of different incisions,they were divided into observation group and control group,45 cases in the observation group was transverse incision,while 47 cases in the control group was longitudinal incision.The levels of perioperative surgical indicators and the incidence of postoperative complications between the two groups of patients were compared.Results There was no significantdifference in operative time,intraoperative blood loss between the two groups（P〉0.05）.The recovery time and hospitalization time of the intestinal function in the observation group were shorter than those in the control group,the pain VAS scores of the observation group at 24 h and 48 h were lower than those in the control group,and the incidence of the disease was lower than that of the control group（P〈 0.05）.Conclusion The lower abdominal assisted transverse incision in laparoscopic radical resection of rectal cancer can reduce the degree of postoperative pain,and reduce the incidence of corresponding complications.