CAJ | 학술논문

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（P<0.05）；此外，腹腔镜组切除淋巴结数与开腹组无显著差异（P>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。
목적：통과여전통적개복Miles술치료저위직장암비교，대비분석무절구조루복강경Miles기술적안전성화가행성。방법회고분석2009년2월～2013년6월아원저위직장암환자Miles술81례，기중복강경조39례，준순전장계막절제（TME）원칙행복강경저위직장암Miles술；개복조42례，행상규개복수술。대비량조환자술중출혈、수술시간、림파결청소수목、술후회복시간、상구유합시간、위장도공능회복시간、술후동통、복벽절구대소등정황。결과복강경조술중출혈량、술후회복시간、장공능회복시간、술후동통、복벽절구대소균명현소우개복조，단기수술시간교장，량조비교존재현저차이（P<0.05）；차외，복강경조절제림파결수여개복조무현저차이（P>0.05）。결론무절구조루복강경저위직장암Miles술치료직장암창상소、강복쾌、안전가고，단기수방효과긍정，치득추엄。
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, fol ow 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 significant difference (P < 0.05); In addition, the laparoscopic resection of lymph node number and laparotomy group had no significant difference (P > 0.05).Conclusions: laparoscopic incision made fistula for the treatment of low rectal cancer Miles colorectal cancer smal trauma, quicker recovery, safe and reliable, short-term fol ow-up effect, is worth promoting.