You Position: Home > Paper
Laparoscopic versus open total mesorectal exision with anal sphincter preservation for low rectal cancer:a randomized trial on short- term outcomes
( views:257, downloads:48 )
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
- Issue:
- 6
- DOI:
- 10.3760/cma.j.issn.1671-0274.2003.06.007
- Key Word:
- 腹腔镜;全直肠系膜切除术;直肠肿瘤 ,低位
Abstract： 目的探索应用腹腔镜技术实施全直肠系膜切除保肛术治疗低位直肠癌的可行性.方法将 171例低位直肠癌患者(肿瘤下缘均位于齿状线以上 1.5～ 7.0 cm内)随机选取 82例行腹腔镜下全直肠系膜切除( TME)保肛术(腹腔镜组);另 89例作为对照组在开腹条件下完成相同手术(开腹组).结果手术均获成功,保肛率 100%.腹腔镜组和开腹组的平均手术时间分别为 120 min和 106 min(P >0.05),术中平均失血量分别为 20 ml和 92 ml(P< 0.05).两组术后镇痛和术后进食时间差异无显著性意义.腹腔镜组较开腹组术后并发症发生率低、胃肠功能恢复快、住院时间短( P< 0.05).腹腔镜组 52例( 63.4%)和开腹组 59例( 66.3%)患者在术后 1个月内恢复控便能力;其余出现不同程度控便能力障碍(大便次数 10～ 20次 /d)的患者,经过药物治疗和括约肌功能训练, 6个月后也逐渐实现了良好的控便.术后随访 1～ 18个月,两组均无腹壁切口种植、局部复发以及死亡病例.结论应用腹腔镜技术实施低位直肠癌 TME保肛术安全可行, 其创伤小、出血少、保肛率高、术后恢复快,是极具应用前景的微创新技术.
- [1]周总光,李立,舒晔,等.腹腔镜全直肠系膜切除保肛治疗低位直肠癌[J].2002,(12).
- [2]Zong-Guang Zhou,Zhao Wang,Yong-Yang Yu,etc.Laparoscopic total mesorectal excision of low rectal cancer with preservation of anal sphincter: A report of 82 cases[J].2003,(7).
- [3]周总光,王昭.直肠癌根治-腔镜下TME：现状与评价[J].2003,(5).
- [4]周总光.微创消化外科的发展与21世纪的医学进步[J].2002,(8).
- [5]周总光.微创化全直肠系膜切除保肛治疗低位直肠癌：机遇与挑战[J].2003,(2).
- [6]李红光,周总光.直肠癌局部转移规律与直肠癌术式的变革[J].2003,(3).
- [7]S, Goldberg,J V, Klas.Total mesorectal excision in the treatment of rectal cancer: a view from the USA.[J].1998,15(2).
- [8]Yong L,Darzi A,Monson JR,etc.Systematic review of laparoscopic surgery for colorectal malignancy.[J].2001,15(12).
- [9]R J, Heald.Total mesorectal excision is optimal surgery for rectal cancer: a Scandinavian consensus.[J].1995,82(10).