不同标本取出方式对腹腔镜下直肠癌Dixon手术患者预后影响.docVIP

不同标本取出方式对腹腔镜下直肠癌Dixon手术患者预后的影响 　　【摘要】 目的：探讨两种不同标本取出方式对腹腔镜下直肠癌Dixon手术患者预后的影响。方法：选择2012年8月-2013年5月在本院普通外科实施腹腔镜下直肠癌Dixon手术的80例患者进行回顾性分析。将患者分为A组和B组，其中A组40例患者的手术标本从左下腹切口拖出后再予以离断。B组40例患者的手术标本首先在腹腔内完成离断，然后装入标本袋内将其取出。结果：所有患者手术顺利，无中转开腹及改行Miles术者，所有患者均未行保护性造瘘。两组患者在手术时间、术中出血量、术后肠道功能恢复时间、术后住院时间、术后并发症发生率上比较差异均无统计学意义（P0.05）；B组患者2年内的复发转移率明显低于A组（P0.05）。结论：取标本是腹腔镜下直肠癌Dixon手术中极其重要的一个环节，必须严格遵循“肿瘤不接触”原则，在腹腔内离断标本并装入标本袋内取出是一种非常合理、安全的标本取出方式，它可以有效降低肿瘤转移的风险。 　　【关键词】 直肠癌； 腹腔镜； 取标本； 预后 　　Influence of Different Specimen Extraction Methods on the Prognosis of Patients with Laparoscopic Anterior Resection for Rectal Cancer（L-Dixon）/YOU Qing， RUAN Can-ping，WANG Zhi-guo.//Medical Innovation of China，2016，13（06）：119-122 　　【Abstract】 Objective：To investigate the influence of different specimen extraction methods on the prognosis of patients who underwent laparoscopic anterior resection of rectal cancer （L-Dixon）. Method： A retrospective analysis was made on the clinical data of 80 cases， who were diagnosed as rectal cancer and treated by laparoscopic anterior resection （L-Dixon） from August 2012 to May 2013 in our hospital. The patients were averagely divided into group A and B. The operation specimens of the group A were extracted from the incision in lower left abdomen and resected outside of the abdomen. While the specimens of the group B were resected in the abdomen and removed through a similar incision by a laparoscopic specimen bag. Result： All the patients got successful operation without a protective stoma and conversion to laparotomy or Miles operation. There were no significant differences about operation time， amount of blood loss， intestinal function recovery and postoperative hospital stay between two groups（P0.05）. For patients in the group B， the recurrence and metastasis rate within 2 years after surgery was significantly lower than that in the group A（P0.05）. Conclusion： Specimen extraction is very important in laparoscopic anterior resection of rectal cancer （L-Dixon）. We mus