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目的探讨腹腔镜下直肠癌腹会阴联合切除术的可靠性及安全性。方法回顾性分析96例直肠癌腹会阴联合切除病例的临床资料,其中腹腔镜手术42例,同期开腹手术病例54例,对比分析腹腔镜与开腹直肠癌腹会阴联合切除术的近期效果。结果腹腔镜组与开腹组所有手术均达到肿瘤根治性切除标准。腹腔镜组与开腹组平均淋巴结清扫数目分别为14.6个和12.3个,术中出血量腹腔镜组少于开腹组,分别为382.0ml和519.4ml;术后排气时间、进食时间及术后患者下床时间腹腔镜组均较开腹组提前,且差异有统计学意义;腹腔镜组与开腹组并发症发生率分别为11.9%和16.7%,无统计学差异。结论腹腔镜直肠癌腹会阴联合切除术是安全可行的,且具有出血少、胃肠功能恢复快、并发症发生率低及术后住院时间短等优势。
Objective To investigate the reliability and safety of laparoscopic abdominal perineal resection for rectal cancer. Methods The clinical data of 96 patients with abdominal perineum combined resection of rectal cancer were retrospectively analyzed. Among them, 42 patients underwent laparoscopic surgery and 54 patients underwent open surgery over the same period. The short-term results of laparoscopic versus abdominal perineal resection for open rectal cancer were compared. Results Laparoscopic group and laparotomy group all achieved radical resection of the tumor. Laparoscopic group and open group, the average number of lymph node dissection were 14.6 and 12.3, intraoperative blood loss laparoscopic group less than the open group, respectively, 382.0ml and 519.4ml; postoperative exhaust time, feeding time and surgery After laparoscopic surgery patients were laparoscopic group were advanced compared with the open group, and the difference was statistically significant; laparoscopic group and open group complication rates were 11.9% and 16.7%, respectively, with no significant difference. Conclusion Laparoscopic rectal peritoninectomy is safe and feasible, with less bleeding, rapid recovery of gastrointestinal function, low complication rate and short postoperative hospital stay.