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腹腔镜低位直肠癌根治术的临床疗效观察.doc

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腹腔镜低位直肠癌根治术的临床疗效观察.doc
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腹腔镜低位直肠癌根治术的临床疗效观 察 谢建平 庞再林 毛红朝 巴中市中心医院普外科 摘 要: 目的:对比分析腹腔镜与开腹低位直肠癌根治术的近期疗效, 探讨总结腹腔镜下 低位直肠癌根治术的应用价值。方法:回顾性分析本院收治的经手术治疗的低位 直肠癌患者128例, 其中腹腔镜下直肠癌根治术为观察组共62例;传统开腹直肠 癌根治术为对照组共 66例。对比分析两组患者一般资料、手术时间、术中出血 量、术后肛门排气时间、住院时间、保肛率、术后并发症发生率及总体经济费用 支出。结果:观察组患者在术中出血量、术后肛门排气时间及住院时间方面明显 短于对照组, 差异具有统计学意义;在术后并发症方面, 观察组发生率 (7/62) 11.3%, 明显低于对照组 (17/66) 25.8%, 差异具有统计学意义;观察组中患者 保肛率 82.3%, 对照组患者保肛率 65.2%, 差异无统计学意义;在经济费用支出 方面, 观察组患者平均住院费用较对照组明显增多, 差异具有统计学意义。 结论: 腹腔镜低位直肠癌根治术安全、 可靠, 患者创伤小、 恢复迅速, 并发症发生率低, 近期效果良好, 值得临床推广应用。 关键词: 腹腔镜; 直肠癌; 临床疗效; 作者简介:谢建平 (1974-) , 男, 副主任医师。E-mail:1192815827@qq.com The investigation of curative effect of laparoscopic resection for lower rectal carcinoma XIE Jian-ping PANG Zai-lin MAO Hong-chao Department of General Surgery, Bazhong Central Hospital; Abstract: Objective: Compare the curative effect of laparoscopic rectal cancer resection and abdominal rectal cancer radical for low rectal cancer, to discussion the value of laparoscopic rectal cancer resection.Methods: The clinical data of 128 patients with low rectal cancer received surgical treatment at our hospital were retrospectively analyzed.62 cases in the observation group were treated with laparoscopic rectal cancer resection, and 68 cases in the control group were treated with routine abdominal rectal cancer resection.The normal information, operative time, the blood loss, the anal exhaust time of postoperative, the hospitalization time, the sphincter preservation rate, the incidence of complications of the postoperative and economic expenses were recorded and compared.Results: The blood loss, the anal exhaust time of postoperative, the hospitalization time in the observation group were significantly lower than that in the control group, the difference was statistically significant (P 0.05) 。 1.2 手术方式 所有患者均采取全身麻醉, 观察组取双腿分开呈“人”字位, 开腹组患者取截 石位, 均行头低足高, 向右倾斜15°。观察组患者实施腹腔镜下直肠癌根治术: 患者成功建立气腹后, 取脐下缘作10 mm横行切口为观察孔, 右下腹麦氏点作 15 mm切口为主操作孔, 取右锁骨中线平脐面行 5 mm辅助操作孔, 于左下腹反 麦氏点行5 mm
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