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中华普通外科学文献简介:中华普通外科学文献简介,中华普通外科学文献简介[详细]

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主管:
中华人民共和国国家卫生健康委员会
主办:
中华医学会
承办:
中山大学附属第一医院
中山大学附属中山医院
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刊 期: 双月刊
创刊时间: 2007年2月
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国际刊号: 1674-0793
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首页 > 期刊列表 > 腹腔镜全直肠系膜联合经肛门内括约肌切除治疗低位直肠癌的疗效探讨
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标题: 腹腔镜全直肠系膜联合经肛门内括约肌切除治疗低位直肠癌的疗效探讨
摘要:

目的:探讨腹腔镜全直肠系膜(TME)联合经肛门内括约肌切除(ISR) 治疗低位直肠癌的疗效,评估手术的安全性。 方法:回顾性分析2009年 1 月至2012 年 12月采用腹腔镜TME联合ISR术治疗的42 例低位直肠肿瘤患者(腹腔镜组),同时选取2006年1月至2012年12月开腹行TME联合ISR术治疗的44例低位直肠肿瘤患者(开腹组)。比较分析两组患者的一般资料、手术情况、临床病理特点、术后并发症和术后生活质量。 结果:两组患者的一般情况和术后临床病理特点相近。腹腔镜组患者均顺利完成手术,总体手术时间(min)明显小于开腹组(181.2±65.4 vs 216.6±82.9,t=2.192,P=0.031),出血量(ml)亦明显小于开腹组(83.2±37.5 vs 117.4±33.0,t=4.495,P﹤0.01)。4例低位直肠癌患者发生吻合口瘘,经保守治疗治愈,并发症发生率与开腹组相比差异无统计学意义。两组患者肛门功能自我评价以及KIRWAN分级差异均无统计学意义。 结论:对于术前评估早中期低位甚至超低位直肠癌,特别是肿瘤没有侵犯肛门内括约肌的患者,采用腹腔镜TME联合ISR术是安全可行的,提高了保肛成功率,保留患者术后肛门括约肌功能,改善生活质量。

英文摘要: Objective:To investigate the effect and safety of laparoscopic total mesorectal excision (TME) combined with intersphincteric resection (ISR) for low rectal cancer. Methods:Forty-two patients of low rectal cancer were performed laparoscopy-assisted TME combined with ISR (laparoscopy-assisted group) from January 2009 to December 2012 and other forty-four cases underwent open surgery (open group) from January 2006 to December 2012. Demographic and perioperative data, including complications and short-term functional outcome were compared between the two groups. Results:Patients of laparoscopy-assisted group successfully underwent operation, and none were transferred to open procedure or laparoscopic Mile's surgery. There were no distribution differences in demographic and perioperative data between the two groups. The average operation time was significantly shorter in laparoscopy-assisted group than in open group (181.2±65.4 min vs 216.6±82.9 min, t=2.192, P=0.031). The laparoscopy-assisted group had less blood loss compared with the open cases (83.2±37.5 ml vs 117.4±33.0 ml, t=4.495, P﹤0.01). The rates of overall complications, infection complications and non-infection complications were similar between the two groups. Anastomotic leakage occurred in 4 cases and they were cured by conservative therapy. The patients of both groups were satisfied with the postoperative anal sphincter function. Conculsions:It is feasible for the appropriate patients with very low rectal cancer to undergo laparoscopic TME combined with ISR, especially for those in early stage, without cancer invasion to the external sphincter. The approach increases the possibility of anal preservation and improves the quality of life.
作者:

章斐然;李威;王怀明;曾永明

作者单位: 汕头大学医学院第一附属医院普通外科
期刊: 中华普通外科学文献(电子版)
年.卷(期):页码 2014 .8(3):204-208
中图分类号:
文章编号:
引用格式: [1]章斐然;李威;王怀明;曾永明.腹腔镜全直肠系膜联合经肛门内括约肌切除治疗低位直肠癌的疗效探讨[J/CD].中华普通外科学文献(电子版),2014,8(3):204-208.
关键词: 低位直肠癌 腹腔镜 开腹手术 全直肠系膜 内括约肌切除
英文关键词: Low rectal cancer;Laparoscopy;Open surgery;Total mesorectal excision; Intersphincteric resection

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