末端回肠悬吊术在腹腔镜低位直肠癌保肛手术中的应用.docxVIP

末端回肠悬吊术在腹腔镜低位直肠癌保 肛手术中的应用 赵辉 赵辉 史益凡 杨增辉 鲍传庆 沈晓明 许炳华 1= 江苏省无锡市第三人民医院胃肠外科 摘要： 目的探讨末端回肠悬吊术在低位直肠癌保肛手术屮的应用价值。方法选取 2015年6月至2017年2月我院诊断为低位直肠癌患者80例，随机分为两组:对 照组(C组)和试验组(T组)，每组各40例。C组行腹腔镜下直肠癌根治术 (Dixon) , T组在C组基础上联合末端回肠悬吊术。分别于术前1 d和术后第1、 3、7天检测两组营养学指标:血浆总蛋白(TP)、血清白蛋白(ALB)、血清前 白蛋白(PA)、转铁蛋白(TF);外周血电解质：钠(Na)、钾K)、氯(CD 等水平，并记录术后首次排气时间、术后住院时间、住院总费用及术后并发症等。 结果两组术前和术后营养指标及血电解质水平差异无统计学意义(P0?05); 术后肛门首次排气时间、术后住院时间、住院总费用及并发症发生率方面差异亦 无统计学意义(P0.05) ;T组吻合口痿的二次手术率明显低于C组，差异有统 计学意义(P0. 05)。结论末端回肠悬吊术不影响患者术后恢复，不增加患者 的痛苦及经济负担，能有效降低由吻合口痿所致的二次手术率，而且操作简便。 关键词： 末端冋肠悬吊术;低位直肠癌;保肛手术;直肠癌根治术; 作者简介：许炳华，E-mail : qdbinghua@sina. com 收稿日期：2017-04-09 基金：江苏省无锡市卫生计生委科研面上项目(编号:MS201619) Application of terminal ileum suspension in laparoscopic operation for low rectai cancer ZHAO Hui SHI Yifan YANG Zenghui BAO Chuanqing SHEN Xiaoming XU Binghua Department of gastrointestinal surgery, The Third People s Hospital of Wuxi; Abstract： Objectivc To explore the value of terminal ileum suspension in the treatment of low rectal can-cer. Methods 80 patients with low rectal cancer who underwent laparoscopic operation in our hospital from June 2015 to February 2017, were randomly divided into two groups: the control group (group C) and the test group (group T) , 40 cases in each group. In group C, laparoscopic radical rcscc tion of rec tai can cor (Dixo n) was per-formed and in group T Dixon was combined with terminal ileum suspension. Peripheral blood nutritional indicators (total plasma protein, albumin, pre~albumin, transferrin) and major electrolytes of two groups were observed 1 day before operation and 1, 3 “nd 7 days after operation. The two groups were compared in terms of first exhausttime, postoperative hospital stay, total costs for hospitalization, postoperative discomforts and complications. Results There were no statistical differences in the levels of nutrition indicators and electrolytes between them (P 0. 05) and nei ther i t was wi th first exhaust time, hospital stay, total costs of hospitalization, inc