腹腔镜辅助Miles手术临床应用研究

Clinical application of the laparoscopic Miles surgery

关键词:  腹腔镜手术  开腹手术  直肠肿瘤

Key words:  rectal neoplasms  laparoscopy  laparotomy

摘要:

［目的］探讨腹腔镜辅助直肠癌Miles手术的可靠性、安全性及有效性。［方法］回顾性分析36例低位直肠癌患者的临床资料。其中，腹腔镜Miles 手术16例，同期开腹Miles手术20例。对比分析两组患者的手术时间、术中出血量、淋巴结清扫数量、术后排气时间、住院时间等。［结果］腹腔镜Miles组术中失血量（235.2±81.9）mL、术后排气时间（44.1±7.8）h均少于开腹Miles手术组（428.7±75.6）mL，（82.5±114）h，差异有显著性意义（P<0.05）。腹腔镜Miles组术后住院时间（11.9±4.2）d、淋巴结清扫数量（15.7±8.3）个，与开腹Miles手术组（14.3±6.4）d，（16.2±7.1）个比较，差异无显著性意义（P>0.05）。［结论］腹腔镜辅助Miles手术是可靠、安全、有效的，而且具有手术创伤小、术中出血量少、术后恢复快等优势。

Abstract:

［Objective］To investigate the safety,efficacy and feasibility of laparoscopic Miles operation for the low rectal cancer.［Methods］The clinical data of 36 patients with low rectal cancer were reviewed retrospectively.Sixteen of these patients received laparoscopic Miles operation and 20 received open resection surgery.The clinical data include the hospital stay, operation time,blood loss,cleared lymph nodes and time of the bowel function recovery.［Results］The average blood loss (235.2±81.9)mL in the operation and the gastrointestinal function recovery time (44.1±7.8)h after operation of laparoscopic Miles surgery were less than those (428.7±75.6)mL and (82.5±114) h of the open procedure (P<0.05).But the number of lymph nodes clearance (15.7±8.3) and hospitalization (11.9±4.2) d of laparoscopic Miles surgery had no significant difference from those (16.2±7.1) and (14.3±6.4) d of the open procedure(P>0.05).［Conclusion］Compared with the open procedure,the laparoscopic Miles surgery had less trauma,less blood loss and quicker recovery.So it is safe,efficient and feasible treatment for the low rectal cancer.