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[目的]总结腹腔镜与传统开放术式在低位直肠癌根治术中的手术方法和效果。[方法]回顾性分析53例行腹腔镜下低位直肠癌根治术的患者的临床资料,总结手术操作经验,同时期50例行传统前入路开放低位直肠癌根治术患者作为对照,比较两组并发症以及术后生存等情况。[结果]腹腔镜组53例患者均成功完成腔镜下手术,其中49例完成Dixon手术,4例术中发现远端切缘肿瘤细胞阳性改行Miles式;开放手术组11例改行Miles式。101例患者获随访,随访时间为17~25个月,平均21个月。腹腔镜组术后出现排尿功能障碍4例,性功能障碍1例;开放手术组出现排尿障碍13例,性功能障碍5例,经过保守治疗后均好转。共5例出现吻合口瘘。3例患者出现切口疝,2例出现复发。[结论]腹腔镜下低位直肠癌根治术相比较传统开放前入路直肠癌根治术是安全可靠的,能减少对盆腔神经的损伤,提高患者术后生存质量,在低位保肛等方面有独到优势。
[Objective] To summarize the surgical methods and effects of laparoscopic and traditional open surgery in radical resection of low rectal cancer. [Methods] The clinical data of 53 patients undergoing laparoscopic radical resection of low rectal cancer were retrospectively analyzed. The experience of operation was summarized. At the same time, 50 patients undergoing open radical resection of low rectal cancer underwent radical resection as control. Complications and postoperative survival. [Results] In the laparoscopic group, 53 patients underwent endoscopic surgery successfully. Among them, 49 patients underwent Dixon operation. Four patients were found to have Miles incision on distal incision tumor cells. In the open operation group, 11 patients were converted to Miles formula. 101 patients were followed up for 17 to 25 months with an average of 21 months. There were 4 cases of voiding dysfunction and 1 case of sexual dysfunction after operation in laparoscopic group. Thirteen cases of voiding dysfunction and 5 cases of sexual dysfunction occurred in open surgery group, all of which were improved after conservative treatment. A total of 5 cases of anastomotic leakage occurred. Three patients had incisional hernia and two had recurrence. [Conclusion] The laparoscopic radical rectal cancer radical resection is safe and reliable compared with the traditional open radical resection of rectal cancer, which can reduce the damage to the pelvic nerves and improve the postoperative quality of life of the patients. Advantage.