| 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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