【摘要】 目的比较腹腔镜下全直肠系膜间切除术(LA-TME)联合经腹或经肛门内括约肌切除术(ISR)治疗低位直肠癌的疗效。方法回顾性分析2009年1月至2016年8月江苏大学附属第一人民医院胃肠外科收治的经电子肠镜检查及病理组织学检查确诊为低位直肠癌的28例患者的临床资料,按照手术方式将其分为经肛ISR组(接受LA-TME联合经肛门内ISR治疗,18例)和经腹ISR组(接受LA-TME联合经腹ISR治疗,10例)。对比分析2组患者的术中情况、术后的病理资料、并发症、肛门功能和预后情况。结果患者手术时间、术中失血量、预防性造口比例、术后住院时间、术后复发率和肛门功能恢复方面组间比较,2组差异无统计学意义(P> 0. 05)。结论 LA-TME联合经腹或经肛门内ISR对低位直肠癌的临床治疗效果相当,均可以作为腹腔镜辅助下ISR治疗低位直肠癌的术式。更多还原

【Abstract】 Objective To compare the efficacy of laparoscopic total mesorectal excision( LA-TME) combined with transabdominal or transanal intersphincteric resection( ISR) in the treatment of low rectal cancer. Methods The clinical data of 28 patients with low rectal cancer diagnosed by electronic enteroscopy and histopathology in the First Affiliated People’ s Hospital of Jiangsu University were retrospectively analyzed. They were divided into the transanal ISR group( underwent LA-TME combined with transanal ISR,18 cases) and the transabdominal ISR group( underwent LA-TME combined with transabdominal ISR,10 cases). The intraoperative conditions,postoperative pathological data,complications,anal function and prognosis of the two groups were compared and analyzed. Results There was no significant difference in the duration of ISR operation,the amount of blood loss during operation,the proportion of prophylactic colostomy,postoperative hospital stays,postoperative recurrence rate and anal function recovery between the two groups( P > 0. 05). Conclusion Effect of LA-TME combined with transabdominal ISR and LA-TME combined with transanal ISR are similar in the clinical treatment of low rectal cancer,and both of the two methods can be used as laparoscopic-assisted ISR in the treatment of low rectal cancer.更多还原