【摘要】 目的:探讨腹腔镜联合经肛门括约肌间径路超低位直肠癌切除的可行性。方法:回顾2010年1月—2012年6月68例行腹腔镜经肛门括约肌间径路超低位直肠癌根治术患者(腔镜组)与同期行76例开腹经肛门括约肌间径超低位直肠癌根治术患者(开腹组)的临床资料,比较两组临床指标与疗效。结果:144例手术均获成功,腔镜组无中转开腹。与开腹组比较,腔镜组手术时间延长[(243.7±40.4)min vs.(150.5±32.1)min],但术中出血量减少[(103.2±10.5)mL vs.(231.6±23.5)mL]、术后切口感染例数减少(1例vs.8例)、肛门排气时间缩短[(2.5±0.6)d vs.(4.6±0.5)d]、住院天数减少[(10.5±0.4)d vs.(14.6±0.3)d],差异均有统计学意义(均P<0.05);两组扫淋巴结数目、吻合口瘘与肠梗阻发生例数,以及术后1年生存率差异均无统计学意义(均P>0.05)。结论:腹腔镜应用于经肛门括约肌间径路超低位直肠癌手术安全可行,并有微创、术后切口感染少等优点。更多还原

【Abstract】 Objective:To evaluate the feasibility of laparoscopic-assisted intersphincteric resection for ultra-low rectal cancer.Methods:The clinical data of 68 patients undergoing laparoscopic-assisted intersphincteric resection for ultralow rectal cancer(laparoscopic group) between January 2010 and June 2012,along with 76 patients undergoing open intersphincteric resection for ultra-low rectal cancer(open surgery group) during the same period were retrospectively studied.The clinical parameters and efficacies between the two groups were compared.Results:Operations were successfully performed in all the 144 patients,and no open conversion was required in laparoscopic group.In laparoscopic group compared with open surgery group,the operative time was prolonged[(243.7±40.4) min vs.(150.5±32.1) min],but the intraoperative blood loss[(103.2±10.5) mLvs.(231.6±23.5)mL],number of cases with postoperative incision infection(1 vs.8),time to flatus[(2.5±0.6) d vs.(4.6±0.5) d],and length of hospital stay[(10.5±0.4) d vs.(14.6±0.3) d]were all decreased,and all the differences had statistical significance(all P<0.05);the difference in number of resected lymph nodes,and number of cases who developed anastomotic fistula or intestinal obstruction,as well as the 1-year postoperative survival between the two groups had no statistical significance(all P>0.05).Conclusion:Laparoscopic-assisted intersphincteric resection for ultra-low rectal cancer is safe and efficient,and it also offers advantages such as minimal invasiveness and reduced postoperative incision infection.更多还原