螺旋水刀在直肠癌全直肠系膜切除术中的应用

目的探讨螺旋水刀在直肠癌全系膜切除术中应用的疗效。方法将110例直肠癌手术患者分为两组,均行全直肠系膜切除术。一组术中应用螺旋水刀进行分离盆腔;另一组不使用螺旋水刀而使用电刀及常规方法分离盆腔。比较两组在手术时间、术中出血、吻合口漏、住院天数、术后局部复发率、暂时性排泄功能紊乱等方面的差别。结果两组在术中所用时间、出血量、术后暂时性排尿功能紊乱发生率差异均有统计学意义(P<0.05),而在住院天数、术后吻合口漏发生率、术后肿瘤局部复发率,差异无统计学意义(P>0.05)。结论应用螺旋水刀行直肠癌全直肠系膜切除术,分离术野清晰、出血少、不易损伤自主神经,尤其对于降低术后暂时性排尿功能紊乱方面有非常明显的效果。

Application of helix Hydro-Jet in total mesorectal excision for rectal carcinoma

Objective To evaluate the superiority of helix Hydro-Jet in total mesorectal excision (TME) for rectal carcinoma. Methods A total of 110 cases with rectal carcinoma were divided into two groups, both of which were treated with TME. Pelvic cavity was removed by using helix Hydro-Jet in one group but by using electrotome and routine method in the other one to compare the difference in aspects of operation time, blood loss, hospital stay, stomal leak, local recurrence rate and temporarily excretive function disorder between both groups. Results The data in both groups were processed with t test and Chi-square analysis. There was statistical difference in operation time, blood loss, local recurrence rate and temporarily excretive function disorder ( P <0.05) but no statistical difference in hospital stay and stomal leak in both groups ( P >0.05). Conclusions TME with helix Hydro-Jet has following advantages including clear visual field, little bleeding, entire excise of carcinoma, low local recurrence rate and without damaging autonomic nerves. TME with helix Hydro-Jet is fairly effective for decreasing postoperative temporary excretive function disorder.