腹腔镜保肛治疗低位直肠癌的临床分析
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[摘要] 目的：探讨经腹腔镜保肛治疗低位直肠癌手术的临床相关问题。方法：收集2005～2010年本院93例低位直肠癌行腹腔镜术保肛治疗低位直肠癌患者，随机分成腹腔镜45例和开放组48例进行治疗；腹腔镜组采用超声刀进行手术，扩肛拖出肛外手工吻合；开放组行一般开放式手术。结果：腹腔镜组出血量[(70±40) ml]、住院时间[(6±4) d]、尿管滞留时间(3 d)、肠道功能恢复时间[(2.8±1.2) d]，与开放组出血量[(120±60) ml]、住院时间[(12±5) d]、尿管滞留时间(7 d)、肠道功能恢复[(4.0±1.5) d]等指标比较，P<0.05；另不完全性肠梗阻(6.7%)和切口感染(0)与开放组的14.6%和12.5%比较差异具有统计学意义(P<0.05)。结论：在临床手术中经腹腔镜保肛治疗低位直肠癌与开放式手术术后差异不大，但术后相关指标腹腔镜组具有优势，且经腹腔镜手术利于保肛、安全可行。
[关键词] 腹腔镜术；直肠癌；手工吻合；安全度
[中图分类号] R735.3+7 [文献标识码]A[文章编号]1674-4721(2011)07(a)-044-02
Clinical analysis of laparoscopic treatment in rectal cancer and anal sphincter preservation
SUN Weihua, SU Meiqi
The Second People′s Hospital of Huaihua City, Hunan Province, Huaihua 418000, China
[Abstract] Objective: To evaluate the anal sphincter preservation with laparoscopic surgery in low rectal cancer related issues. Methods: Open to the general open-surgery group were collected in 2005 to 2010 years, 93 patients in our hospital for laparoscopic rectal cancer surgery and anal sphincter preservation in patients with low rectal cancer, 45 patients were randomized into the laparoscopic group and open group of 48 patients treated; Harmonic scalpel laparoscopic surgery group were. Expansion outside the anus out of hand anal anastomosis; Open surgery group were generally open. Results: Laparoscopic group, the amount of bleeding [(70±40) ml], hospital stay [(6±4) d], catheter retention time (3 d), bowel function recovery time [(2.8±1.2) d], the amount of bleeding and open group [(120±60) ml], hospital stay [(12±5) d], catheter retention time (7 d)，recovery of bowel function [(4.0±1.5) d] Other indicators P<0.05; Another incomplete intestinal obstruction (6.7%) and wound infection (0) with the open group 14.6% and 12.5% comparison also statistically significant(P<0.05). Conclusion: Laparoscopic surgery in the clinical treatment of rectal cancer with anal sphincter preservation surgery for open little difference. But after the laparoscopic group has an advantage related indicators, laparoscopic surgery and the anus help, safe and feasible.
[Key words] Laparoscopy; Rectal cancer; Hand suture; Safety
直肠癌的发病和死亡数近年来正在呈现上升的趋势且越发年轻化[1]，在经济逐步发展的今天人们除了对根治肿瘤提出要求 ......
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