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[目的]探讨腹腔镜TME技术在低位、超低位直肠癌保肛手术中的应用效果。[方法]选取2009年6月~2011年2月在某院确诊为直肠癌患者100例,全部病例随机分为两组:腹腔镜组与开腹组各50例。比较两组的手术质量评价指标:手术时间、出血量、肛门恢复排气时间、淋巴结数等;及近期疗效评价指标:切口感染、吻合口瘘、肠粘连、术后尿潴留、住院时间等。[结果]与开腹组比较,腹腔镜组的手术时间短(P﹤0.05),出血量少(P﹤0.05),肛门恢复排气时间快(P﹤0.05),淋巴结数目达到开腹水平(P﹥0.05)。腹腔镜发生切口感染、吻合口瘘、肠粘连、术后尿潴留的发生率明显降低(P﹤0.05)。且腹腔镜组的住院时间短于开腹组(P﹤0.05)。[结论]腹腔镜TME技术应用于低位、超低位直肠癌保肛手术中疗效确切,具有手术时间短、出血量少、肛门恢复排气时间快、术后并发症发生率低等优点,值得临床推广。
[Objective] To investigate the effect of laparoscopic TME technique in anus preservation of low and ultralow rectal cancer. [Methods] A total of 100 patients with rectal cancer diagnosed in a hospital from June 2009 to February 2011 were selected. All patients were randomly divided into two groups: laparoscopic group and laparotomy group of 50 cases. The operation quality evaluation index was compared between the two groups: operation time, blood loss, exhaust time of anus recovery, number of lymph nodes, etc .; and recent curative effect evaluation index: incision infection, anastomotic fistula, intestinal adhesion, postoperative urinary retention, hospitalization time and so on. [Results] Compared with the open group, laparoscopic group had shorter operative time (P <0.05), less bleeding (P <0.05), faster anal exhaust time (P <0.05) P> 0.05). Laparoscopic incision infection, anastomotic fistula, intestinal adhesion, postoperative urinary retention was significantly lower (P <0.05). The length of stay in laparoscopic group was shorter than that in laparotomy group (P <0.05). [Conclusion] The application of laparoscopic TME technique in the anus preservation surgery of low and ultralow rectal cancer is effective. It has the advantages of short operation time, less bleeding, fast recovery of anus and low incidence of postoperative complications. Promotion.