经阴道拖出切除标本的腹腔镜下直肠癌根治术的临床体会

Clinical study of laparoscopic-assisted transvaginal radical resection for rectal cancer

目的了解经阴道拖出切除标本的腹腔镜下直肠癌根治术的安全性及可行性。方法选取28例直肠癌患者,13例(A组)接受经阴道拖出切除标本的腹腔镜下根治术治疗,15例(B组)接受传统腹腔镜下直肠癌根治术治疗。比较两组的手术时间、术中出血、术后住院时间、胃肠功能恢复时间、术后并发症发生情况及短期肿瘤结局。结果A组的手术时间长于B组(P<0.05),胃肠功能恢复和住院时间均短于B组(P<0.01),术后并发症及短期肿瘤结局与B组比较差异无统计学意义(P>0.05)。结论与传统腹腔镜直肠癌根治术相比,经阴道拖出切除标本的腹腔镜下直肠癌根治术操作相对困难,耗时较长,但能缩短术后恢复时间,避免腹部切口,达到美容效果,安全可行。

Objective To explore the safety and feasibility of laparoscopic- assisted transvaginal radical resection for rectal cancer.Methods Twenty-eight patients with rectal cancer were divided into two groups.Group A (13 cases) received laparoscopic-assisted transvaginal radical resection while Group B (15 cases) received conventional laparoscopic radical resection.The operation time,intraoperative bleeding,postoperative hospital stay,gastrointestinal function recovery time, postoperative complications and short-term tumor outcomes were compared between the two groups.Results Group A had the operation time longer than Group B (P<0.05),and had the gastrointestinal function recovery time and postoperative hospital stay shorter than Group B (P<0.01).There was no statistical difference between the two groups in terms of postoperative complications and short-term tumor outcomes.Conclusion Although laparoscopic-assisted transvaginal radical resection is more difficult and takes longer time compared with conventional laparoscopic radical resection,it can shorten postoperative recovery time,avoid abdominal incision and achieve excellent cosmetic results.It is a safe and feasible option.