中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2015年
4期
721-723
,共3页
直肠癌%腹腔镜%D3根治%盆腔自主神经
直腸癌%腹腔鏡%D3根治%盆腔自主神經
직장암%복강경%D3근치%분강자주신경
Rectal carcinoma%Laparoscope%D3 radical correction%Pelvic autonomic nerve preservation
目的 探讨腹腔镜直肠癌D3淋巴结清扫联合盆底自主神经保留术的疗效及安全性.方法 分析我院2010年以来行直肠癌D3淋巴结清扫联合盆底自主神经保留术的211例患者的临床资料,其中腹腔镜组131例和开腹组80例,并对两组的统计结果进行比较.结果 所有患者均顺利完成手术,腹腔镜组手术时间为(3.33±0.72)h,术后1～4d下床活动,术后平均排气时间为(3.48 ±0.82)d,术后病理报告切除淋巴结数(14.94±3.41)枚/例,无手术死亡病例,术后并发症发生率为12.2％(16/131),其中切口感染9例,肺部感染2例,吻合口瘘1例,吻合口出血4例.腹腔镜组与开腹组比较,两组淋巴结清扫数目(P＞0.05)和术后并发症(P＞0.05)的差异无统计学意义,腹腔镜组术后排气时间(P＜0.01)和住院时间(P＜0.05)低于开腹组,开腹组手术时间(P＜0.01)低于腹腔镜组,两者差异有统计学意义(P＜0.05).腹腔镜组术后性功能和排尿功能障碍与开腹组比较,差异无统计学意义(P＞0.05).结论 腹腔镜下直肠癌D3淋巴结清扫联合盆底自主神经保留手术是安全可行的,且患者术后恢复快,具有明显的微创优势,同时提高了患者术后的生存质量.
目的 探討腹腔鏡直腸癌D3淋巴結清掃聯閤盆底自主神經保留術的療效及安全性.方法 分析我院2010年以來行直腸癌D3淋巴結清掃聯閤盆底自主神經保留術的211例患者的臨床資料,其中腹腔鏡組131例和開腹組80例,併對兩組的統計結果進行比較.結果 所有患者均順利完成手術,腹腔鏡組手術時間為(3.33±0.72)h,術後1～4d下床活動,術後平均排氣時間為(3.48 ±0.82)d,術後病理報告切除淋巴結數(14.94±3.41)枚/例,無手術死亡病例,術後併髮癥髮生率為12.2％(16/131),其中切口感染9例,肺部感染2例,吻閤口瘺1例,吻閤口齣血4例.腹腔鏡組與開腹組比較,兩組淋巴結清掃數目(P＞0.05)和術後併髮癥(P＞0.05)的差異無統計學意義,腹腔鏡組術後排氣時間(P＜0.01)和住院時間(P＜0.05)低于開腹組,開腹組手術時間(P＜0.01)低于腹腔鏡組,兩者差異有統計學意義(P＜0.05).腹腔鏡組術後性功能和排尿功能障礙與開腹組比較,差異無統計學意義(P＞0.05).結論 腹腔鏡下直腸癌D3淋巴結清掃聯閤盆底自主神經保留手術是安全可行的,且患者術後恢複快,具有明顯的微創優勢,同時提高瞭患者術後的生存質量.
목적 탐토복강경직장암D3림파결청소연합분저자주신경보류술적료효급안전성.방법 분석아원2010년이래행직장암D3림파결청소연합분저자주신경보류술적211례환자적림상자료,기중복강경조131례화개복조80례,병대량조적통계결과진행비교.결과 소유환자균순리완성수술,복강경조수술시간위(3.33±0.72)h,술후1～4d하상활동,술후평균배기시간위(3.48 ±0.82)d,술후병리보고절제림파결수(14.94±3.41)매/례,무수술사망병례,술후병발증발생솔위12.2％(16/131),기중절구감염9례,폐부감염2례,문합구루1례,문합구출혈4례.복강경조여개복조비교,량조림파결청소수목(P＞0.05)화술후병발증(P＞0.05)적차이무통계학의의,복강경조술후배기시간(P＜0.01)화주원시간(P＜0.05)저우개복조,개복조수술시간(P＜0.01)저우복강경조,량자차이유통계학의의(P＜0.05).복강경조술후성공능화배뇨공능장애여개복조비교,차이무통계학의의(P＞0.05).결론 복강경하직장암D3림파결청소연합분저자주신경보류수술시안전가행적,차환자술후회복쾌,구유명현적미창우세,동시제고료환자술후적생존질량.
Objective To investigate the safety and efficacy of laparoscopic D3 radical correction with pelvic autonomic nerve preservation for rectal cancer.Methods The clinical deta of 211 patients with rectal cancer underwent D3 radical correction with pelvic autonomic nerve preservation in our hospital from 2010 to 2014 were retrospectively analyzed,they were divided into two groups (laparoscopic group,n =131 ; open group,n =80),the statistical results of the two groups were compared.Results All the operated patients was successful,211 cases were successfully completed surgery.The laparoscopic group mean operative time was (3.33 ± 0.72) h,ambulation began within 1-4 days postoperatively,the average time for passage of flatus was (3.48 ±0.82) d,the median number of total lymph nodes removed was 14.94 ± 3.41.The postoperative complications were observed in 16 of 131 cases (12.2％) including incision infection in 9 cases,Pulmonary infection in 2 cases,anastomotic fistula in 1 cases,anastomotic bleeding in 4 cases,no anastomotic fistula occurred.No significant difference in the number of total lymph nodes removed (P ＞ 0.05) and the postoperative complications (P ＞ 0.05) was observed between the two groups.Bowel flatus passed and hospital stay (P ＜ 0.05) earlier (P ＜ 0.01) in laparoscopic than that in open group.Operative time shorter (P ＜ 0.01) in open than that in laparoscopic group.no significant difference in urinary dysfunction and sexual dysfunction after operation was observed between the two groups.Conclusion Laparoscopic D3 radical correction with pelvic autonomic nerve preservation for rectal cancer is feasible and safe,quick postoperative recovery,has the obvious advantage of minimally invasive,and the life quality of patients is higher.
