中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2013年
24期
1921-1923
,共3页
吴国举%肖刚%周新平%赵刚%贾文焯%余涛%安琦%杨华%龙海空
吳國舉%肖剛%週新平%趙剛%賈文焯%餘濤%安琦%楊華%龍海空
오국거%초강%주신평%조강%가문작%여도%안기%양화%룡해공
腹腔镜检查%直肠肿瘤%腹腔镜腹会阴联合切除术
腹腔鏡檢查%直腸腫瘤%腹腔鏡腹會陰聯閤切除術
복강경검사%직장종류%복강경복회음연합절제술
Laparoscopy%Rectal neoplasms%Laparoscopic abdominoperineal excision
目的 探讨腹腔镜联合提肛肌外腹会阴联合切除术(LELAPE)在低位直肠癌治疗中的可行性.方法 回顾性分析2011年6月至2013年1月北京医院胃肠外科35例低位直肠癌患者病例资料,20例行传统截石位腹腔镜腹会阴联合切除术(LAPE)者为LAPE组,其中男12例、女8例,平均年龄(63±6)岁；LELAPE组15例先取平卧位行腹腔镜腹部手术,再取折刀位行经提肛肌外会阴部手术,其中男10例、女5例,平均年龄(61±7)岁.应用t检验对比两组患者手术及术后恢复情况.结果 LELAPE和LAPE组患者手术时间、术后开始下床活动时间、肠功能恢复时间、会阴部刀口拆线时间、术后住院时间差异均无统计学意义[(259±52)比(246±55) min、(35±13)比(33±9)d,(61 ±25)比(63 ±20)h,(15.7±2.5)比(16.8±2.9)d,(12±3)比(15 ±4)d,均P＞0.05]；分别发生2例和3例并发症(P＞0.05)；LELAPE组会阴部术中出血量更少、拔除会阴部引流管时间更早[(76±31)比(148±36) ml,(6.2±1.6)比(10.3±l.8)d,均P＜0.05].结论 LELAPE治疗低位直肠癌安全可行,较传统截石位手术具有一定优势.
目的 探討腹腔鏡聯閤提肛肌外腹會陰聯閤切除術(LELAPE)在低位直腸癌治療中的可行性.方法 迴顧性分析2011年6月至2013年1月北京醫院胃腸外科35例低位直腸癌患者病例資料,20例行傳統截石位腹腔鏡腹會陰聯閤切除術(LAPE)者為LAPE組,其中男12例、女8例,平均年齡(63±6)歲；LELAPE組15例先取平臥位行腹腔鏡腹部手術,再取摺刀位行經提肛肌外會陰部手術,其中男10例、女5例,平均年齡(61±7)歲.應用t檢驗對比兩組患者手術及術後恢複情況.結果 LELAPE和LAPE組患者手術時間、術後開始下床活動時間、腸功能恢複時間、會陰部刀口拆線時間、術後住院時間差異均無統計學意義[(259±52)比(246±55) min、(35±13)比(33±9)d,(61 ±25)比(63 ±20)h,(15.7±2.5)比(16.8±2.9)d,(12±3)比(15 ±4)d,均P＞0.05]；分彆髮生2例和3例併髮癥(P＞0.05)；LELAPE組會陰部術中齣血量更少、拔除會陰部引流管時間更早[(76±31)比(148±36) ml,(6.2±1.6)比(10.3±l.8)d,均P＜0.05].結論 LELAPE治療低位直腸癌安全可行,較傳統截石位手術具有一定優勢.
목적 탐토복강경연합제항기외복회음연합절제술(LELAPE)재저위직장암치료중적가행성.방법 회고성분석2011년6월지2013년1월북경의원위장외과35례저위직장암환자병례자료,20례행전통절석위복강경복회음연합절제술(LAPE)자위LAPE조,기중남12례、녀8례,평균년령(63±6)세；LELAPE조15례선취평와위행복강경복부수술,재취절도위행경제항기외회음부수술,기중남10례、녀5례,평균년령(61±7)세.응용t검험대비량조환자수술급술후회복정황.결과 LELAPE화LAPE조환자수술시간、술후개시하상활동시간、장공능회복시간、회음부도구탁선시간、술후주원시간차이균무통계학의의[(259±52)비(246±55) min、(35±13)비(33±9)d,(61 ±25)비(63 ±20)h,(15.7±2.5)비(16.8±2.9)d,(12±3)비(15 ±4)d,균P＞0.05]；분별발생2례화3례병발증(P＞0.05)；LELAPE조회음부술중출혈량경소、발제회음부인류관시간경조[(76±31)비(148±36) ml,(6.2±1.6)비(10.3±l.8)d,균P＜0.05].결론 LELAPE치료저위직장암안전가행,교전통절석위수술구유일정우세.
Objective To explore the feasibility of laparoscopic with extralevator abdominoperineal excision (LELAPE group) for low rectal cancer.Methods From June 2011 to January 2013,35 patients with low rectal cancer undergoing laparoscopic abdominoperineal excision at the Department of Gastroenterological Surgery,Beijing Hospital were analyzed retrospectively.Among them,20 received laparoscopic abdominoperineal excision (LAPE group).There were 12 males and 8 females with an average age of (63 ± 6) years old.Another 15 patients underwent laparoscopic extralevator abdominoperineal excision (LELAPE group).There were 10 males and 5 females with an average age of (61 ±7) years old.Operative duration,blood loss volume,time of postoperative out-of-bed activity,recovery of gastrointestinal function,removal time of drainage tube,edge of perineal position take out stitches time,postoperative hospital stay and complication rates were relative analyzed.Results There was no significant difference in operative time,time of postoperative out-of-bed activity,recovery of gastrointestinal function,removal time of perineal stitches,postoperative hospital stay and complication rates between 2 groups ((259 ± 52) vs (246±55) min,(35±13) vs (33±9) d,(61 ±25) vs (63±20) h,(15.7±2.5) vs (16.8±2.9) d,(12 ± 3) vs (15 ± 4) d,2/15 vs 3/20,all P ＞ 0.05).Blood loss volume of perineal position in LELAPE group was less than those in LAPE group ((76 ± 31) vs (148 ± 36) ml,P ＜ 0.05).Removal of perineal drainage tube in LELAPE group was earlier than that in LAPE group ((6.2 ± 1.6) vs (10.3 ± 1.8) d,P ＜0.05).Conclusion LELAPE is a safe and feasible surgical approach for low rectal cancer.
