无切口造瘘腹腔镜与开腹Miles术81例对比研究.docVIP

精品论文 参考文献 无切口造瘘腹腔镜与开腹Miles术81例对比研究 韩云 秦伟 李晓峰 杨生虎 杨立平 李雅 沈启莲 　　（青海大学附属医院腹部腔镜外科 青海西宁 810001） 　　 　　【摘要】目的 通过与传统的开腹Miles术治疗低位直肠癌比较，对比分析无切口造瘘腹腔镜Miles技术的安全性和可行性。方法 回顾分析2009年2 月～2013 年6 月我院低位直肠癌患者Miles术８1例，其中腹腔镜组39例，遵循全肠系膜切除（TME）原则行腹腔镜低位直肠癌Miles术；开腹组42例，行常规开腹手术。对比两组患者术中出血、手术时间、淋巴结清扫数目、术后恢复时间、伤口愈合时间、胃肠道功能恢复时间、术后疼痛、腹壁切口大小等情况。结果 腹腔镜组术中出血量、术后恢复时间、肠功能恢复时间、术后疼痛、腹壁切口大小均明显少于开腹组，但其手术时间较长，两组比较存在显著差异（Plt;0.05）；此外，腹腔镜组切除淋巴结数与开腹组无显著差异（Pgt;0.05）。结论 无切口造瘘腹腔镜低位直肠癌Miles术治疗直肠癌创伤小、康复快、安全可靠，短期随访效果肯定，值得推广。 　　【关键词】低位直肠癌 无切口造瘘 腹腔镜Miles术 开腹Miles术 　　【中图分类号】R735.3+7 【文献标识码】A 【文章编号】1672-5085（2013）49-0074-03 　　No incision made colon colostomy in 81 cases of laparoscopic and open Miles contrast research 　　Yun Han , Wei Qin , Xiaofeng li, Shenghu Yang, Liping Yang, Ya li , Qilian Shen 　　(Qinghai university affiliated hospital abdominal laparoscopic surgery, Xining Qinghai , 810001) 　　【abstract】 objective: through Miles with the traditional laparotomy surgery in the treatment of low rectal cancer, comparative analysis made no incision fistula safety and feasibility of laparoscopic Miles technology. Methods: retrospective analysis in February 2009 to June 2013 from 81 cases of patients with low rectal cancer in Miles, 39 cases of laparoscopic group, follow the principle of the mesenteric excision (TME) line of laparoscopic rectal cancer low Miles; Open group of 42 cases, conventional laparotomy. Compared to two groups of patients with intraoperative bleeding, operation time, number of lymph node cleaning, postoperative recovery time, wound healing time, gastrointestinal function recovery time, postoperative pain, abdominal incision size, and so on and so forth. Results: the laparoscopic group of intraoperative blood loss, postoperative recovery time, bowel function recovery time, postoperative pain, abdominal incision size were significantly less than laparotomy group, but its operation for a long time, the two groups was significa