摘要
[目的]总结腹腔镜与传统开放术式在低位直肠癌根治术中的手术方法和效果。[方法]回顾性分析53例行腹腔镜下低位直肠癌根治术的患者的临床资料,总结手术操作经验,同时期50例行传统前入路开放低位直肠癌根治术患者作为对照,比较两组并发症以及术后生存等情况。[结果]腹腔镜组53例患者均成功完成腔镜下手术,其中49例完成Dixon手术,4例术中发现远端切缘肿瘤细胞阳性改行Miles式;开放手术组11例改行Miles式。101例患者获随访,随访时间为17~25个月,平均21个月。腹腔镜组术后出现排尿功能障碍4例,性功能障碍1例;开放手术组出现排尿障碍13例,性功能障碍5例,经过保守治疗后均好转。共5例出现吻合口瘘。3例患者出现切口疝,2例出现复发。[结论]腹腔镜下低位直肠癌根治术相比较传统开放前入路直肠癌根治术是安全可靠的,能减少对盆腔神经的损伤,提高患者术后生存质量,在低位保肛等方面有独到优势。
[PurposelTo summarize the surgery methods and results of laparoscopic and open radical resections in patients with low rectal cancer. [Methods] Clinical data of 53 cases with low rectal cancer undergoing laparoscopic radical surgery were analyzed retrospectively, and the operation experience was summarized. Fifty cases with low rectal cancer undergoing traditional open radical surgery were as controls. Complications and survival of the two groups were analyzed. [Results] All of 53 patients in laparoscopic group completed laparoseopic radical surgery suecessfully,and among them,49 cases completed Dixon surgery,4 cases converted to Miles surgery due to intraoperative positive distal margin;And 11 cases converted to Miles surgery in open surgery group. A total of 101 cases were followed up for 17-25 months （mean 21 months）.There were urination dysfunction in 4 cases and sexual dysfunction in 1 case in laparoseopic group, while 13 cases and 5 canes in open surgery group respectively,and the symptoms were all improved after conservative treatment. In the two groups, there were 5 cases with anastomotic leak, 3 cases with incisional hernia,and 2 cases with recurrence. [Conclusion] Compared to traditional open surgery,laparoscopic radical resection for low rectum cancer is safe and effective. It is able to reduce the pelvic nerve damage,improve patients＇ quality of life, and has a unique advantage in anal sparing.
出处
《肿瘤学杂志》
CAS
2015年第1期21-25,共5页
Journal of Chinese Oncology
基金
黎介寿院士专项基金(LJS201302)
云南省卫生系统领军人才培养计划(L-201205)
云南省科技创新人才计划(2012HC013)
关键词
直肠肿瘤
腹腔镜
吻合口瘘
rectal neoplasms
laparoscopy
anastomotic leak
