CAJ | 학술논문

目的比较两种会阴操作方法在经腹会阴联合直肠癌根治术(abdominoperineal resection,APR)中的应用.方法回顾性分析2007-2009年收治的60例直肠癌患者的临床资料.60例直肠癌的肿瘤均位于直肠前壁,30例采用改良会阴操作法(改良组)实施APR手术,另30例采用传统会阴操作法(传统组)实施APR手术,比较两组手术的时间、会阴操作时的直肠(肿瘤)破裂、尿道(阴道)损伤、术后会阴并发症发生等情况.对数据进行t检验或χ2检验.结果会阴操作时间:改良组平均为45(45±15)min,传统组平均为70(70±20)min,两组比较差异有统计学意义(t=5.48,P＜0.05);术中直肠(肿瘤)破裂:改良组2例,传统组5例,两组差异无统计学意义(χ2=0.64,P＞0.05);尿道(阴道)损伤:改良组无,传统组1例,两组比较差异无统计学意义(χ2=0,P＞0.05);会阴切口感染/裂开:改良组2例,传统组9例,两组比较差异有统计学意义(χ2=4.01,P＜0.05).结论改良组会阴操作比传统组手术时间短,手术更安全,术后并发症少.
목적 비교량충회음조작방법재경복회음연합직장암근치술(abdominoperineal resection,APR)중적응용.방법 회고성분석2007-2009년수치적60례직장암환자적림상자료.60례직장암적종류균위우직장전벽,30례채용개량회음조작법(개량조)실시APR수술,령30례채용전통회음조작법(전통조)실시APR수술,비교량조수술적시간、회음조작시적직장(종류)파렬、뇨도(음도)손상、술후회음병발증발생등정황.대수거진행t검험혹χ2검험.결과 회음조작시간:개량조평균위45(45±15)min,전통조평균위70(70±20)min,량조비교차이유통계학의의(t=5.48,P＜0.05);술중직장(종류)파렬:개량조2례,전통조5례,량조차이무통계학의의(χ2=0.64,P＞0.05);뇨도(음도)손상:개량조무,전통조1례,량조비교차이무통계학의의(χ2=0,P＞0.05);회음절구감염/렬개:개량조2례,전통조9례,량조비교차이유통계학의의(χ2=4.01,P＜0.05).결론 개량조회음조작비전통조수술시간단,수술경안전,술후병발증소.
Objective To compare the safety and effectiveness of two methods of perineal dissection in 60 consecutive patients of rectal carcinoma undergoing combined abdominoperineal resection.Methods In this retrospective study from 2007 to 2009, 30 cases underwent Miles' operation using modified method of perineal dissection( MM group) and 30 cases undergoing Miles' operation using classic method of perineal dissection ( CM group). Operative time, accidental tumor ( or rectal) perforation during the procedure, iatrogenic injury to the urethra ( or vagina) and postoperative perineal complications were compared between the two groups. Results The mean perineal operative time was (45±15) min in MM group and ( 70 ± 20) min in CM group respectively ( t = 5. 48, P ＜ 0. 05 ). There were no significant differences in the rate of tumor ( or rectal) perforation and that of urethral (vaginal) injury. There were significant difference in the rate of postoperative perineal complications (χ2=4.01, P＜0.05).Conclusions Modified method of perineal dissection is effective and safe, and this method offers a new approach for the perineal dissection during Miles' operation.