CAJ | 학술논문

目的探讨手助腹腔镜( HALS)直肠癌全直肠系膜切除(TME)根治术的临床效果.方法选择沈阳军区总医院普通外科2010年1月至2011年3月期间住院手术的42例直肠癌患者,分别采用HALS(HALS组,19例)和腹腔镜辅助(腹腔镜辅助组,23例)进行TME直肠癌根治手术,并对两组患者的临床效果进行对比分析.结果两组患者手术均顺利完成,手术切缘均为阴性.HALS组和腹腔镜辅助组手术时间分别为(152±17) min和(168±19) min(t=-2.767,P=0.009)；Dixon手术切口长度分别为中位数5.6 cm和4.5 cm (P=0.000)；住院费用分别为2.6万元和2.9万元(P=0.008)；而术中失血量、清除淋巴结数、术后排气时间和住院时间两组差异无统计学意义(均P＞0.05).结论 HALS直肠癌TME根治术同样具备腹腔镜辅助手术微创、安全、术后恢复快和创伤小的优点.
목적 탐토수조복강경( HALS)직장암전직장계막절제(TME)근치술적림상효과.방법 선택침양군구총의원보통외과2010년1월지2011년3월기간주원수술적42례직장암환자,분별채용HALS(HALS조,19례)화복강경보조(복강경보조조,23례)진행TME직장암근치수술,병대량조환자적림상효과진행대비분석.결과 량조환자수술균순리완성,수술절연균위음성.HALS조화복강경보조조수술시간분별위(152±17) min화(168±19) min(t=-2.767,P=0.009)；Dixon수술절구장도분별위중위수5.6 cm화4.5 cm (P=0.000)；주원비용분별위2.6만원화2.9만원(P=0.008)；이술중실혈량、청제림파결수、술후배기시간화주원시간량조차이무통계학의의(균P＞0.05).결론 HALS직장암TME근치술동양구비복강경보조수술미창、안전、술후회복쾌화창상소적우점.
Objective To study the feasibility of hand-assisted laparoscopic radical resection of rectal carcinoma and compare the short-term outcomes of HALS versus traditional laparoscopy approach.Methods Clinical data of 42 cases of rectal carcinoma between January 2010 and March 2011 were enrolled in this study.Nineteen cases underwent HALS total mesorectal excision and 23 cases underwent traditional laparoscopy approach.Results All the operations were successfully accomplished without conversions to open surgery.The mean operation time of the HALS group was shorter than that of the traditional laparoscopic group (152 min vs.168 min,P=0.009).Incision length was significantly longer in the HALS group(5.6 cm vs.4.5 cm,P=0.000).The median overall costs were lower in HALS group (26 000 RMB vs.29 000 RMB,P=0.008).The number of lymph nodes in resected specimen,intraoperative blood loss,length of hospital stay,time to passage of flatus were comparable between the two groups.Conclusions Hand-assisted laparoscopic surgery has the advantages of laparoscopic surgery including minimal invasiveness,safety,and quicker postoperative recovery.