摘要
目的探讨腹腔镜梗阻性低位直肠癌保肛手术的可行性。方法回顾性分析昆明医科大学附属曲靖医院2012年1月至2015年12月梗阻性低位直肠癌保肛治疗(Dixon)45例手术患者的临床资料(保肛组),与同期的50例行腹会阴联合直肠癌根治术(Miles)患者对照(对照组)。结果保肛组发生肠瘘6例(6/45,13.3%),经充分引流后肠瘘愈合;局部肿瘤复发5例,转移3例;无死亡病例。保肛组的术中出血量(120±3)ml及术后住院时间(9±1)d,与Miles术比较有优势。结论只要病例选择适当,辅以术中结肠灌洗和(或)预防性造瘘,对于梗阻性低位直肠癌可以采用腹腔镜保肛手术治疗,不但能够恢复良好的排便、控便功能,而且可以达到和Miles术相同的根治范围,取得类似的疗效。
Objective To explore the feasibility of sphincter-preserving operation for low rectal carcinoma. Methods Retrospective analysis of low rectal carcinoma of obstruction of sphincter-preserving operation（ Dixon） surgery in patients with clinical data of 45 cases from our hospital between Jan. 2012 and Dec. 2015. Results Intestinal fistula from obstructive low rectal carcinoma sphincter-preserving operation group ,including 6 cases （6/45,13.3%） with full drainage after intestinal fistula healing,5 cases of local recurrence,3 cases with metastasis. Without any death after operations. In the Sphincter-preserving operation group, there was an advantage in the amount of bleeding （120 ± 3 ） ml and postoperative hospital stay （9 ±1） d. Conclusions The appropriate cases selected, surgery or colonic irrigation and preventive colostomy for obstructive rectal carcinoma decreases can be used laparoscopic sphincter-preserving operation, which is not only able to recover a good bowel movement and then control functions, but also can be achieved Miles and the same radical surgery, obtaining the similar effect.
出处
《中华腔镜外科杂志（电子版）》
2016年第6期348-350,共3页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
关键词
直肠癌
梗阻性
低位
保肛手术
肠痿
Rectal carcinoma
Obstructive
Low
Sphincter- preserving operation
Fistula
