开腹与腹腔镜ISR术式治疗Ⅱ～Ⅲ期低位直肠癌保肛的对比分析

doi:10.3969/j.issn.2095-378X.2017.03.005

外科研究与新技术 ›› 2017, Vol. 6 ›› Issue (3): 162-164.doi: 10.3969/j.issn.2095-378X.2017.03.005

开腹与腹腔镜ISR术式治疗Ⅱ～Ⅲ期低位直肠癌保肛的对比分析

梁炳英

江苏省无锡市锡山区中医医院普外科,无锡 214194

收稿日期:2017-05-15 发布日期:2019-12-11
作者简介:梁炳英(1975—),男,主治医师,本科,从事外科手术治疗;电子信箱:f093221@126.com

Comparative analysis of laparotomy and laparoscopic intersphincteric resection in treatment of stage Ⅱ-Ⅲ low rectal cancer

LIANG Bingying

Department of General Surgery,Wuxi Traditional Chinese Medicine Hospital,Wuxi 214194,China

Received:2017-05-15 Published:2019-12-11

摘要/Abstract

摘要： 目的对比分析开腹与腹腔镜内外括约肌间切除术(intersphincteric resection,ISR)Ⅱ～Ⅲ期低位直肠癌保肛中的临床疗效。方法选取普外科治疗的70例Ⅱ～Ⅲ期低位直肠癌保肛患者,随机分为观察组(腹腔镜ISR术)和对照组(开腹ISR术),对比两组术后的临床指标、并发症和转移复发率。结果观察组术中出血量[(94.68±18.76) mL]、肛门首次排气时间[(1.21±0.36) d]、住院时间[(9.54±1.39) d]均显著优于对照组[(203.22±35.18) mL、(2.18±0.67)d、(12.73±1.52)d,P＜0.05],而手术时间、术中淋巴结清扫数等差异无统计学意义。术后并发症(11.4%)、转移复发(5.7%)也明显低于对照组(37.1%、22.9%,P＜0.05)。结论相较于开腹ISR手术,腹腔镜ISR手术具有较高的临床疗效,较低的术后并发症和转移复发率,值得临床推广。

关键词: 开腹手术, 腹腔镜ISR手术, 低位直肠癌

Abstract: Objective To analyze and compare the clinical effects of laparotomy and laparoscopic intersphincteric resection (ISR) in the preservation of rectal cancer at stage Ⅱ-Ⅲ.Methods A total of 70 patients with stage Ⅱ-Ⅲ low rectal cancer were selected from Department of General Surgery and randomly divided into an observational group (laparotomy ISR) and a control group (laparoscopic ISR).The clinical indicators,incidence rate of postoperative complications,and recurrence rate between the two groups were compared.Results The observation group showed significantly less intraoperative blood loss volume[(94.68±18.76) mL vs.(203.22±35.18) mL],shorter first anal exsufflation time[(1.21±0.36) d vs.(2.18±0.67) d],and shorter hospital stay[(9.54±1.39) d vs.(12.73±1.52) d] than the control group (P<0.05),but no differences in operation time and the number of lymph node dissection were observed.The incidence rate of postoperative complications (11.43% vs.37.14%) and recurrence rate (5.71% vs.22.86%) in the observation group were also significantly lower than those of the control group (P<0.05).Conclusion Compared with laparotomy ISR,laparoscopic ISR has a better clinical therapeutic effect and lower postoperative complication rate and recurrence rate;therefore,it is worthy of clinical application.

Key words: Laparotomy, Laparoscopic intersphincteric resection, Low rectal cancer

中图分类号:

梁炳英. 开腹与腹腔镜ISR术式治疗Ⅱ～Ⅲ期低位直肠癌保肛的对比分析[J]. 外科研究与新技术, 2017, 6(3): 162-164.

LIANG Bingying. Comparative analysis of laparotomy and laparoscopic intersphincteric resection in treatment of stage Ⅱ-Ⅲ low rectal cancer[J]. Surgical Research and New Technique, 2017, 6(3): 162-164.

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开腹与腹腔镜ISR术式治疗Ⅱ～Ⅲ期低位直肠癌保肛的对比分析

Comparative analysis of laparotomy and laparoscopic intersphincteric resection in treatment of stage Ⅱ-Ⅲ low rectal cancer

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