作　　者： (蒋光富）; (陈尚武）; (姜明）;

机构地区： 广安市人民医院普外二科,四川广安638000

出　　处： 《临床和实验医学杂志》 2017年第18期1866-1869,共4页

摘　　要： 目的腹腔镜辅助Dixon手术治疗高龄患者低位直肠癌的临床应用价值和安全性。方法选取2013年10月至2015年2月治疗的72例低位直肠癌高龄患者为研究对象,随机分为对照组及研究组。对照组患者给予腹腔镜辅助Miles术方法治疗,研究组患者给予腹腔镜辅助Dixon手术方法治疗。对两组患者手术一般项目、术中淋巴结清扫个数、术后癌残留数术后安全性、术后生理功能恢复情况以及术后1年后复发率和死亡率进行比较。结果 (1)研究组在手术一般项目方面均显著少于对照组(P<0.05)。(2)两组患者术中淋巴结清扫个数和术后癌残留数比较均无显著差异(P>0.05)。(3)两组患者术后并发症的发生率比较无显著差异(P>0.05)。(4)研究组36例患者中排尿功能分级为1级的患者有16例,2级患者有11例,3级患者有7例,4级患者有2例。研究组患者术后排尿功能显著优于对照组(P<0.05)。(5)两组患者术后1年内复发率和死亡率比较无显著差异(P>0.05)。结论与腹腔镜辅助Miles手术相比,腹腔镜辅助Dixon手术治疗高龄患者低位直肠癌的肿瘤根治效果良好,术后并发症较少,并可以实现肛门功能的最大程度保留,改善患者的生活质量。 Objective To compare the clinical efficacy and safety between Laparoscopic assisted Dixon surgery and Laparoscopic assisted Miles surgery on geriatric patients with low rectal cancer. Methods A total of 72 geriatric patients with low rectal cancer from October 2013 to February 2015 were selected as study subjects. The patients were randomly divided into research group and control group. The observation group were performed Laparoscopic assisted Miles surgery while research group was treated with Laparoscopic assisted Miles surgery. General operation projects,amount of lymph node dissection during operatio,residual cancer after surgery,postoperative safety,postoperative physiological function recovery,recurrence rate and mortality rate after 1 year of the two groups were compared. Results（1）Operation time,intraoperative blood loss and postoperative drainage volume of the control group were statistically higher than those of the research group（ P〈0. 05）.（2）Amount of lymph node dissection during operation and residual cancer after surgery had no statistical difference（ P〉0. 05）.（3）The postoperative complications of the two groups had no statistical difference（ P〉0. 05）.（4）In the research group,there were 16 patients with urination function classification of grade 1,11 patients with grade 2,7 patients with grade 3,2patients with grade 4. The urination function of the research group were statistically better than that of the control group（ P〈0. 05）.（5） The recurrence rate and mortality rate after 1 year of the two groups had no statistical difference（ P〉0. 05）. Conclusion The application of Laparoscopic assisted Dixon surgery on geriatric patients with low rectal cancer has advantages of good curative effect on cancer and fewer postoperative complications. And it can meet the maximum preservation of anal function. That is to say,the application of Laparoscopic assisted Dixon surgery should be widely used on geriatric patients with low rectal cancer.

关 键 词： 低位直肠癌 高龄患者 腹腔镜 手术 临床疗效 安全性