中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (03): 203-205.

• 论著 • 上一篇    下一篇

腹腔镜经盆腔入路括约肌间超低位直肠前切除术治疗直肠癌可行性研究

池    畔，林惠铭，卢星榕，黄    颖   

  1. 福建医科大学附属协和医院普外科大肠组，福建福州350001
  • 出版日期:2010-03-01 发布日期:2010-03-12

  • Online:2010-03-01 Published:2010-03-12

PDF

摘要：

目的    探讨在腹腔镜下完成肠系膜切除、直接经盆腔途径行括约肌间超低位直肠切除治疗低位直肠癌是否可行。方法    2008年1月至2009年7月福建医科大学协和医院普外科共收治47例直肠癌（癌肿下缘距肛缘4~5cm），予行经括约肌间超低位直肠前切除（ISR），符合入组标准的37例，其中腹腔镜组21例，开腹组16例，两组的一般资料有可比性。结果    并发症：腹腔镜组4例（乳糜漏2例、吻合口出血与粘连性肠梗阻各1例），开腹组5例（肺部感染3例、乳糜漏与尿潴留各1例），两组差异无统计学意义；排便功能（Vaizey评分）：腹腔镜组与开腹组分别为0~9（2.4+2.4）分与0~8（2.4+2.4）分，两组差异无统计学意义。预后：两组至今尚未发现局部转移与复发病例。结论    行腹腔镜经盆腔入路括约肌间超低位直肠前切除术是可行与安全的。

关键词: 腹腔镜, 直肠癌, 括约肌间超低位直肠前切除术

Abstract:

Laproscopic pelvic approach to ISR for ULAR        CHI Pan,LIN Hui-ming,LU Xing-rong, et al. General Surgery, Union Hospital, Fujian Medical University, Fuzhou 350001, China
Corresponding author: CHI Pan, E-mail: cp3169@163.com
Objective    To investigate the feasibility of pelvic approach directly to intersphincteric resection (ISR) for ultra-lower anterior resection (ULAR) when undergoing laproscopic total mesenteric excision (TME).Methods    A total of 47 patients with a rectal cancer at a distance of 4~5cm from anal verge had an ISR from January 2008 to July 2009.Thirty-seven patients were included according to the review standards. Laparoscopic group included 21 patients and open group 16 patients.Results    The general information between two groups is comparability.(1)Complications:Four patients in laparoscopic group had the complications such as chylus leak in 2 cases,stoma bleeding in 1 case and adhesive ileus in 1 case.Five patients in open group had such as pulmonary infection in 3 cases, chylus leak in 1 case and urinary retention in 1 case.(2)Fecal function (Vaizey score):It was (2.4±2.4) (0~9 score) in laparoscopic group and (2.4±2.4) (0~8 score) in open group.There was no significant difference of fecal function in two groups.(3)Prognosis:The case of local metastasis and recurrence in two groups have not been found up to now.Conclusion    Laproscopic pelvic approach to ISR for ULAR is feasible and safety.

Key words: laproscopic, recal cancer, intersphincteric resection