


标题: | 腹腔镜经肛门结肠肛管吻合在超低位直肠癌保肛手术中的应用 |
摘要: |
目的:探讨腹腔镜下超低位直肠癌根治术并经肛门结肠肛管吻合术(腹腔镜改良Parks手术)的临床应用。方法:回顾性分析2008年12月至2013年4月期间28例腹腔镜改良Parks手术患者(腹腔镜组)和56例开腹手术者(开腹组)的临床资料,探讨其术后并发症以及肛门植物神经功能状况。结果:所有患者随访6~52个月,腹腔镜组术后出现吻合口瘘2例(7.1%),全部行二次横结肠造口手术,出现1例吻合口狭窄,2例排尿困难。开腹组术后出现吻合口瘘5例(8.9%),2例行二次横结肠造口手术,3例经局部引流通畅,静脉肠外营养支持后瘘口闭合,其他4例并发症主要为性功能和排尿困难。腹腔镜组术后3个月内4例(14.3%)患者出现排便功能障碍,而随着时间的增加,排粪功能优的患者比例并未下降(χ2=0.778,P=0.678)。结论:腹腔镜改良Parks手术可以有效提高超低位直肠癌患者的的保肛率,手术并发症并未增高,术后有较满意的控粪、排尿功能。 |
英文摘要: | Objective:To explore the clinical application of transanal colo-anal anastomosis in laparoscopic anterior resection for ultra-low rectal cancer (laparoscopic modified Parks operation). Methods:The clinical data of twenty eight cases with laparoscopic modified Parks operation and fifty-six cases with open surgery from December 2008 to April 2013 were retrospectively analyzed. The postoperative complications and anal vegetative nerve function were then discussed. Results:Patients were followed up for 6-52 months. In the laparoscopy group, 2 cases (7.1%) experienced anastomotic leakage, who underwent a transverse colostomy. The anastomotic stricture appeared in 1 case, and dysuresia appeared in 2 cases. In the open surgery group, the anastomotic leakage appeared in 5 cases (8.9%), of whom 2 cases underwent a transverse colostomy and conservative management was implemented in the other 3 cases. Sexual dysfunction and dysuresia appeared in 4 cases. Four cases in the laparoscopic group appeared to have dysporia within 3 months and the patients with good anal continence remained constant as time went by (χ2=0.778, P=0.678). Conclusion:The laparoscopic modified Parks operation can effectively improve the sphincter-preserving rate for ultra-low rectal cancer with satisfactory anal continence and urinary function without increasing complications. |
作者: |
杨世斌1;邓量1;李明哲1;黎文峰1;韩方海2;肖隆斌1 |
作者单位: | 广州,中山大学附属第一医院东院普通外科1;中山大学附属第二医院胃肠外科2 |
期刊: | 中华普通外科学文献(电子版) |
年.卷(期):页码 | 2016 .10(2):116-119 |
中图分类号: | |
文章编号: | |
引用格式: | [1]杨世斌1;邓量1;李明哲1;黎文峰1;韩方海2;肖隆斌1.腹腔镜经肛门结肠肛管吻合在超低位直肠癌保肛手术中的应用[J/CD].中华普通外科学文献(电子版),2016,10(2):116-119. |
关键词: | 直肠肿瘤 腹腔镜 结肠肛管吻合 超低位 |
英文关键词: | Rectal neoplasms;Laparoscopy;Transanal colo-anal anastomosis;Ultra-low |
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