直肠癌腹腔镜Dixon术与传统Dixon术的临床效果对比分析.doc

直肠癌腹腔镜Dixon术与传统Dixon术的临床效果对比分析 朱晒红△ 叶飞 刘岩 李鹏洲 朱利勇 谭娟 （中南大学湘雅三医院普通外科， 湖南长沙 410003） 摘要： 目的 对比腹腔镜直肠癌Dixon术与传统Dixon术两种手术方式的优缺点。方法 对我院2005年9月至2010年8月期间326例行腹腔镜下直肠癌Dixon术与传统Dixon术的患者临床资料作回顾性对比分析。 结果 腹腔镜直肠癌Dixon术手术时间、胃肠功能恢复和住院时间较传统开腹Dixon术时间短，术中出血量较传统Dixon术少，术后镇痛方面较传统手术有优越性，术后粘连性肠梗阻发生率较传统手术少、术后吻合口瘘发生率及肿瘤复发率两者无显著性差异。结论 腹腔镜直肠癌Dixon与传统Dixon手术相比，术中出血少，创伤小，术后恢复好，具有明确的微创优势，是安全可行的。 关键词：腹腔镜；直肠癌；Dixon手术； 中图分类号：R.37 文献标识码：AComparison of laparoscopic and openradical by Dixon of rectal carcinoma ZHU Shai-hong△, YE Fei ,LIU Yan, LI Peng-zhou, ZHU Li-yong, TAN Juan The general surgery of The third xiangya hospital of central south university,410013,Changsha,china ABSTRACT: Objective Laparoscopic Dixon of rectal carcinoma compared with the advantages and disadvantages of openradical Dixon rectal carcinoma. Methods The 326 cases of clinical data of Laparoscopic Dixon and openradical Dixon during September 2005 to August 2010 were retrospectively analyzed. Results The operation time, recovery time of gastrointestinal function, hospitalization stay of laparoscopic group was shorter than that of the openradical group, the intra- operative blood loss of the laparoscopic group was obviously less than that of the open group 70±10 ml vs 120±15 ml, p 0.01 , postoperative pain than traditional surgery has advantages, the incidence of postoperative adhesive intestinal obstruction less than traditional surgery and the incidence of postoperative anastomotic leakage, and tumor recurrence rate was no significant difference between the two. Conclusion Compared with the openradical,laparoscopic group has less bleeding, less trauma and earlier recovery of function of these benefits and has a clear advantage of minimally invasive, Security. Key words: Laparoscopic; Rectal carcinoma;Dixon; Chinese Library Classification: R735.37 Document code?: A 前言 直肠癌是乙状结肠直肠交界处至齿状线之间的癌，消化道常见的恶性肿瘤，占消化道癌的第二位。其发病原因尚不清楚，可能相关因素包括：饮食及致癌物质，直肠慢性炎症，遗传易感性，以及癌前期疾病如家族性肠息肉病等。病理分型为：肿块型、浸润型和溃疡型。直肠癌的诊断根据病史、体检、影像学和内镜检查不难作出诊断，准确率可