| 罗亮,张永川,沈攀.腹腔镜下经肛门括约肌间切除超低位直肠癌 158例分析[J].安徽医药,2020,24(12):2470-2473. |
| 腹腔镜下经肛门括约肌间切除超低位直肠癌 158例分析 |
| Comparative study of three laparoscopic transanal sphincter resection in the treatment of 158 patients with ultra?low rectal cancer |
| |
| DOI：10.3969/j.issn.1009?6469.2020.12.034 |
| 中文关键词: 直肠肿瘤 腹腔镜检查 结直肠外科手术 肛管 |
| 英文关键词: Rectal neoplasms Laparoscopy Colorectal surgery Anal canal |
| 基金项目: |
|
| 摘要点击次数: 1584 |
| 全文下载次数: 526 |
| 中文摘要: |
| 目的探讨腹腔镜下部分切除、次全切除及完全切除经肛门括约肌间切除术(Intersphincter resection，ISR)术式对 Ⅰ～Ⅲ期超低位直肠癌病人肛门功能、安全性及生存结局的影响。方法回顾性分析达州市中心医院 2013年 1月至 2016年 1月收治 Ⅰ～Ⅲ期超低位直肠癌病人共 158例临床资料，根据手术方案不同分为 A组(54例)、 B组(70例)及 C组(34例)，分别采用腹腔镜下部分切除、次全切除及完全切除 ISR术式治疗；比较三组围手术期临床指标，术后肛门功能相关指标、吻合口相关并发症发生率及随访结局指标。结果三组手术时间、术中出血量、淋巴结清扫数目及术后住院时间比较差异无统计学意义(P＞0.05)；三组术后排便急迫率、止泻药物依赖率、失禁率、 Wexner失禁评分及 Kinwan失禁分级比较差异无统计学意义(P＞0.05)；三组术后吻合口周围黏膜缺血、吻合口瘘、直肠阴道瘘及直肠坏死发生率比较差异无统计学意义(P＞0.05)； A组、 B组及 C组术后吻合口慢性狭窄发生率分别为 9.26%，10.00%，29.41%(P＜0.05)；三组术后复发率、 3年无病生存率及无局部复发生存率比较差异无统计学意义(P＞0.05)。结论腹腔镜下部分切除、次全切除及完全切除 ISR术式治疗 Ⅰ~Ⅲ期超低位直肠癌在术后肛门功能保护和生存结局方面均较为接近；但完全切除 ISR术式应用可能增加术后吻合口慢性狭窄发生风险。 |
| 英文摘要: |
| Objective To investigate the influence of partial resection，subtotal resection and total resection intersphincteric resec? tion(ISR)operation by laparoscopy on anal function，safety and survival outcomes of patients with utra?low rectal cancer for stage Ⅰ to Ⅲ.Methods One hundred and fifty?eight patients with utra?low rectal cancer for stage Ⅰ to Ⅲ in Dazhou Central Hospitalfrom January 2013 to January 2016 were chosen and assigned into 3 groups according to operation scheme，including A group(54 patients)with partial resection ISR，B group(70 patients)with subtotal resection ISR and C group(34 patients)with total resec? tion ISR operation by laparoscopy.The perioperative clinical indicators，postoperative anal function related indicators，incidence of anastomotic complications and outcome indicators with follow?up of 3 groups were compared.Results There was no significant dif? ference in the operation time，intraoperative blood loss，lymph node dissection number and postoperative hospital staying time among 3 groups(P＞0.05).There was no significant difference in the postoperative defecation urgent rate，antidiarrheal drug depen? dence rate，incontinence rate，Wexner incontinence score and Kinwan incontinence classification among 3 groups(P＞0.05).There was no significant difference in incidence of postoperative anastomotic mucosal ischemia，anastomotic leakage，rectovaginal fistula and rectal necrosis among 3 groups(P＞0.05).The incidence of postoperative chronic anastomotic stenosis in A group，B group and C group were 9.26%，10.00% and 29.41%，respectively(P＜0.05).There was no significant difference in postoperative recurrence rate，disease?free survival rate and relapse free survival rate in 3 year with follow?up among 3 groups(P＞0.05).Conclusion Par? tial resection，subtotal resection and total resection ISR operation by laparoscopy in the treatment of patients with utra?low rectalcancer for stage Ⅰ to Ⅲ possess the same postoperative anal function preservation and survival outcome；but total resection ISR op? eration by laparoscopy application maybe increase the chronic anastomotic stenosis risk after surgery. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
