CAJ | 학술논문

目的探讨腹骶联合切除术治疗低位进展期直肠癌的可行性和安全性.方法前瞻性入组2010年6月至2012年1月间兰州军区兰州总医院收治的可行局部根治性切除但又难以保留肛门的97例低位进展期直肠癌患者,按入院顺序交替分为腹会阴组(49例,行腹会阴联合切除术)和腹骶组(48例,行腹骶联合切除术).比较两组患者的术中及术后情况.结果两组患者手术顺利,无围手术期死亡.与腹会阴组相比,腹骶组手术时间(包括第2次调整体位的时间)明显延长[(188±45) min比(143±48) min,P=0.000],非计划性前列腺或阴道损伤发生率降低[0比14.3％(7/49),P=0.032],会阴部切口感染率降低[2.1％(1/48)比18.4％(9/49),P=0.040].结论腹骶联合切除术应用于中低位直肠癌患者安全、可行.
목적 탐토복저연합절제술치료저위진전기직장암적가행성화안전성.방법 전첨성입조2010년6월지2012년1월간란주군구란주총의원수치적가행국부근치성절제단우난이보류항문적97례저위진전기직장암환자,안입원순서교체분위복회음조(49례,행복회음연합절제술)화복저조(48례,행복저연합절제술).비교량조환자적술중급술후정황.결과 량조환자수술순리,무위수술기사망.여복회음조상비,복저조수술시간(포괄제2차조정체위적시간)명현연장[(188±45) min비(143±48) min,P=0.000],비계화성전렬선혹음도손상발생솔강저[0비14.3％(7/49),P=0.032],회음부절구감염솔강저[2.1％(1/48)비18.4％(9/49),P=0.040].결론 복저연합절제술응용우중저위직장암환자안전、가행.
Objective To explore the feasibility and safety of abdominosacral resection for patients with locally advanced primary low rectal cancer.Methods A total of 97 low rectal cancer patients were amenable to surgery but not anal sphincter preservation were included in this study and divided into the abdominoperineal resection group (n=49) and abdominosacral resection group (n=48) according to the order of alternative admission time between June 2010 and January 2012.Intraoperative and postoperative parameters were compared between the two groups.Results The surgery went well and no perioperative mortality in the two groups.Compared with abdominoperineal resection group,the operative time of abdominosacral resection group(including the 2nd position adjustment time) was longer [ (188±45) min vs.(143±48) min,P=0.000],the unexpected prostate or vagina injury incidence was lower [0 vs.14.3％(7/49),P=0.032),and the perineal wound infection rate was lower [2.1％ (1/48)vs.18.4％ (9/49),P=0.040].Conclusion Abdominosacral excision is feasible and safe for patients with locally advanced primary low rectal cancer.