腹腔镜联合部分内括约肌切除在低位直肠癌保肛根治术中的应用

目的评价低位直肠癌患者行腹腔镜辅助部分内括约肌切除保肛根治术的安全性和可行性。 方法回顾性分析2011年1月至2014年12月60例在汕头大学医学院第二附属医院行腹腔镜辅助低位直肠癌保肛术患者的资料，其中30例行部分内括约肌切除术(pISR组)，30例行全内括约肌切除保肛术(tISR组)，两组进行肿瘤安全性、术后肛门控制功能等方面的比较。 结果pISR组与tISR组在肿瘤安全性比较，差异无统计学意义(P>0.05)；术后plSR组肛门功能良好率高于tISR组，术后分期比较，差异有统计学意义(20、24、26例) vs (17、20、21例)，(10、6、4例) vs (13、10、9例)，P < 0.05]。 结论腹腔镜联合部分内括约肌切除行低位直肠癌保肛根治术是安全可行的，能更好地保留肛门控制排便功能。

Application of laparoscopic-assisted partial intersphincteric resection for ultralow rectal carcinoma

ObjectiveTo evaluate the application of laparoscopic-assisted partial intersphincteric resection(ISR)for ultralow rectal carcinoma. MethodsFrom Jan. 2011 to Dec. 2014, laparoscopic-assisted pISR and laparoscopic-assisted tISR were performed respectively in 30 patients with ultralow rectal carcinoma.Oncologic safety and postoperative defecation functions were compared between the two groups. ResultsPostoperative defecation functions in the laparoscopic-assisted pISR group were significantly better than that in the laparoscopic-assisted tISR group(P> 0.05). There were no significant differences in oncologic safety between the two groups.After the median follow up of 24 months, there was no local recurrence and distant metastasis in the two groups(20、24、26 patients) vs (17、20、21 patients), (10、6、4 patients) vs (13、10、9 patients), P< 0.05]. ConclusionsLaparoscopic-assisted pISR was a better way to keep the defecation functions for ultralow rectal carcinoma.