双入路法在腹腔镜下游离结肠脾曲直肠癌保肛术中的应用
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摘要
目的分析双入路法在腹腔镜下游离结肠脾曲的直肠癌保肛术中的应用效果。方法选择我院收治的实施直肠癌保肛术患者75例进行观察,收治时间为2016年8月至2018年6月,随机分成两组后给予常规组37例患者实施传统侧方入路治疗,给予治疗组38例患者实施双入路法在腹腔镜下游离结肠脾曲治疗,对比两组直肠癌患者的手术治疗效果差异。结果治疗组直肠癌保肛术患者治疗后的淋巴结清扫数量、术后引流量、肿瘤距肛门距离、切除标本长度、术后排气时间、术后康复时间、并发症发生率、手术保肛率及治疗优良率均明显优于常规组直肠癌保肛术患者(P<0. 05),差异具有统计学意义。结论针对直肠癌保肛术患者实施双入路法在腹腔镜下游离结肠脾曲的治疗效果十分显著,促进患者预后,提高保肛术治疗效果。
Objective To analyze the application effect of the double-entry approach in rectal cancer anus-preserving surgery with laparoscopy downstream from colon and spleen curvature. Methods 75 patients with rectal cancer who underwent anal preservation surgery by double-entry approach with colon-spleen curvature laparoscopy from August 2016 to June 2018 in our hospital were selected for observation. They were randomly divided into two groups with 37 cases in conventional group and 38 cases in treatment group. The conventional group was given the traditional lateral approach,while the treatment group was treated through the double approach. The differences of surgical treatment effects between two groups of rectal cancer patients were compared. Results The patients in the treatment group were obviously better than those in conventional group in terms of the number of lymph node dissection,the postoperative drainage,distance between tumor and anus,length of excised specimen,postoperative exhaust time,postoperative recovery time,postoperative complications,rate of preserving anus during operation and excellent rate after surgery,with statistically significant difference( P<0. 05). Conclusion For rectal cancer patients with anal preservation surgery,the double-entry approach with laparoscopy downstream from colon and spleen curvature is significant to promote the prognosis of patients and improve the effects of anal preservation surgery.
Objective To analyze the application effect of the double-entry approach in rectal cancer anus-preserving surgery with laparoscopy downstream from colon and spleen curvature. Methods 75 patients with rectal cancer who underwent anal preservation surgery by double-entry approach with colon-spleen curvature laparoscopy from August 2016 to June 2018 in our hospital were selected for observation. They were randomly divided into two groups with 37 cases in conventional group and 38 cases in treatment group. The conventional group was given the traditional lateral approach,while the treatment group was treated through the double approach. The differences of surgical treatment effects between two groups of rectal cancer patients were compared. Results The patients in the treatment group were obviously better than those in conventional group in terms of the number of lymph node dissection,the postoperative drainage,distance between tumor and anus,length of excised specimen,postoperative exhaust time,postoperative recovery time,postoperative complications,rate of preserving anus during operation and excellent rate after surgery,with statistically significant difference( P<0. 05). Conclusion For rectal cancer patients with anal preservation surgery,the double-entry approach with laparoscopy downstream from colon and spleen curvature is significant to promote the prognosis of patients and improve the effects of anal preservation surgery.
引文
[1]刘超,文习刚,鲁妍.腹腔镜下结肠脾曲游离的手术技巧[J].腹腔镜外科杂志,2017,22(3):190-193.
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[6]杨梓锋,吴德庆,李勇.结肠脾曲癌之腹腔镜辅助左半结肠癌根治术[J].中华结直肠疾病电子杂志,2016,5(1):98-100.
[7]池畔,王枭杰.左半结肠切除术的争议和基于膜解剖的脾曲游离技巧[J].中华结直肠疾病电子杂志,2017,6(4):284-289.
[8]刁德昌,万进,王伟,等.以胰腺为导向的腹腔镜下结肠脾曲游离技术[J].消化肿瘤杂志:电子版,2015,7(3):136-139.
[2]沈荐,李敏哲,杜燕夫,等.腹腔镜直肠癌前切除术中保留左结肠动脉与否的临床对照研究[J].中国微创外科杂志,2014,20(1):22-24.
[3]陈斌,陈健健,李柳生.腹腔镜直肠癌根治术中吻合口张力探讨[J].中华腔镜外科杂志(电子版),2016,9(4):248-250.
[4]刘飞,张李安.腹腔镜直肠癌前切除术中保留左结肠动脉与否的临床对照研究[J].临床和实验医学杂志,2017,16(10):1013-1016.
[5]潘凯.腹腔镜结直肠癌根治术中结肠血管变异的应对措施[J].中华胃肠外科杂志,2013,16(10):944-946.
[6]杨梓锋,吴德庆,李勇.结肠脾曲癌之腹腔镜辅助左半结肠癌根治术[J].中华结直肠疾病电子杂志,2016,5(1):98-100.
[7]池畔,王枭杰.左半结肠切除术的争议和基于膜解剖的脾曲游离技巧[J].中华结直肠疾病电子杂志,2017,6(4):284-289.
[8]刁德昌,万进,王伟,等.以胰腺为导向的腹腔镜下结肠脾曲游离技术[J].消化肿瘤杂志:电子版,2015,7(3):136-139.