悬吊式腹腔镜辅助手术在直肠癌治疗中的应用

目的:对比悬吊式腹腔镜(悬吊组)与气腹腹腔镜(气腹组)在直肠癌手术中的应用效果。方法:回顾分析我科收治的58例直肠肿瘤患者行腹腔镜手术的临床资料。悬吊组32例,气腹组26例;分别记录手术时间、术中出血量、清除淋巴结数。结果:手术时间:悬吊组100～310min,平均(201.6±68.2)min;气腹组100～480min,平均(261.9±129.3)min;P=0.038;术中出血量:悬吊组100～260ml,平均(144.4±51.8)ml;气腹组80～600ml,平均(261.9±129.3)ml;P=0.025;清除淋巴结数:悬吊组11～25枚,平均(15.5±3.5)枚;气腹组11～44枚,平均(17.2±6.4)枚;P=0.209。气腹组术中损伤输尿管1例,中转开腹2例;两组各1例吻合口漏。结论:与气腹腹腔镜相比,悬吊式腹腔镜辅助直肠癌根治术是一种更为安全可行的手术方式,可成为心肺功能较差患者的一种选择。

The application of abdominal wall lifting laparoscopy in rectal neoplasm therapy

Objective:To compare the application effectiveness of abdominal wall lifting laparoscopy(AWLL) with pneumoperitoneum laparoscopy(PPL) in rectal surgery.Methods:Fifty-eight patients underwent AWLL and pneumoperitoneum laparoscopic rectal tumorectomy in our department.Among the total,32 patients underwent AWLL and 26 patients underwent PPL tumorectomy.Operating time,bleeding volume and lymph node clearance were separately recorded.Results:All the operations were successful.The operating time in AWLL group was 100-310min,mean(201.6±68.2)min,in PPL group was 100-480min,mean(261.9±129.3)min;P=0.038.The bleeding volume in AWLL group was 100-260ml,mean(144.4±51.8)ml;in PPL group was 80-600ml,mean(261.9±129.3)ml;P=0.025.The results were significantly different between these two groups.The number of lymph node clearance in AWLL group was 11-25,mean(15.5±3.5),in PPL group was 11-44,mean(17.2±6.4);The result was not significantly different between these two groups(P=0.209).One case took place injury of ureter and two cases transformed to open operations in the PPL group.During postoperative period of rectectomy,one case took place stoma fistula in both groups.Conclusions:By compared with PPL,AWLL is safer and more effective.It possibly becomes the choice for patients,especially whom with bad cardiorespiratory functions.