腹腔镜辅助直肠全系膜切除术治疗低位直肠癌的可行性、安全性及近期临床效果.docVIP

腹腔镜辅助直肠全系膜切除术治疗低位直肠癌的可行性、安全性及近期临床效果 　　[摘要]目的 探讨腹腔镜辅助直肠全系膜切除术治疗低位直肠癌的可行性、安全性及近期临床效果。方法 选取2009年7月～2011年7月来我院就诊并接受治疗的114例低位直肠癌患者作为研究对象，根据手术方式的差异分为研究组及对照组，每组57例，对照组应用常规的开腹手术进行治疗，研究组则选择腹腔镜辅助直肠全系膜切除术治疗，比较两组的可行性、安全性及近期临床疗效。结果 研究组在住院时间、排气时间、导管留置时间、手术时间以及术后出血量指标上明显优于对照组，差异有统计学意义（P0.01）。术后，研究组患者出血、尿潴留、切口感染、尿路感染以及肠梗阻的发生率明显低于对照组，差异有统计学意义（P0.05）。随访研究组患者1、3、5年生存率明显高于对照组（P0.01）；其复发率为3.51%，低于对照组的12.28%，差异有统计学意义（P0.01）。结论 腹腔镜辅助直肠全系膜切除术治疗低位直肠癌有着明显的临床效果，且安全性较高，可有效改善其临床指标，对提高生存率及降低复发率均有着积极的意义，值得推广。 　　[关键词]腹腔镜；直肠全系膜切除术；低位直肠癌；切口感染；尿潴留；生存率 　　[中图分类号] R735.3+7 [文献标识码] A [文章编号] 1674-4721（2016）10（c）-0056-03 　　[Abstract]Objective To explore the feasibility，safety and short term clinical efficacy of laparoscopic assisted total rectal excision in the treatment of low rectal cancer.Methods 114 patients with low rectal cancer treated in our hospital from July 2009 to July 2011 were taken as the research objects and divided into study group and control group according to the different surgical methods，with 57 cases in each group.Patients in the control group were treated with conventional open surgery，while patients in the study group were treated with laparoscopic assisted total rectal excision.The feasibility，safety and clinical efficacy between two groups were analyzed and compared.Results Hospitalization time，exhaust time，catheter indwelling time，operation time and postoperative bleeding volume in the study group was significantly better than that in the control group，and the difference was statistically significant （P0.01）.After surgery，incidence rate of bleeding，urinary retention，incision infection，urinary tract infection and intestinal obstruction in the study group was significantly lower than that in the control group，and the difference was statistically significant （P0.05）.After follow-up，1，3，5 year survival rate in the study group was significantly higher than that in the control group（P0.01）； the recurrence rate was lower than that in the control group （3.51% vs 12.28%），and the