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目的探讨腹腔镜行TME+保肛手术治疗低位直肠癌的安全性和可行性。方法回顾分析近3年半笔者采用腹腔镜行TME+保肛改良手术治疗低位直肠癌18例患者的临床资料。结果18例手术均顺利完成。手术时间(165.2±45.6)min,术中出血量(146.7±84.5)mL,术后腹腔引流量(170.1±47.2)mL,术后肛门排气时间(3.1±0.7)d,术后住院时间(8.7±1.4)d,淋巴结清除数(12.1±3.2)枚。手术后大便次数增加5例,均在1年左右恢复至近正常状态。无输尿管损伤、排尿障碍、大便失禁及吻合口瘘等并发症。结论腹腔镜行TME+保肛手术治疗低位直肠癌是安全、可行的,体现了手术微创的优越性。
Objective To investigate the safety and feasibility of laparoscopic TME + anal sphincter preservation surgery for low rectal cancer. Methods The clinical data of 18 patients with low rectal cancer treated with laparoscopic TME + anal sphincter preservation surgery during the past three and a half years were retrospectively analyzed. Results 18 cases were successfully completed. The operative time (165.2 ± 45.6) min, intraoperative blood loss (146.7 ± 84.5) mL, postoperative abdominal drainage volume (170.1 ± 47.2) mL, postoperative anal exhaust time (3.1 ± 0.7) d, postoperative hospital stay 8.7 ± 1.4) d, lymph node clearance (12.1 ± 3.2) pieces. Stool frequency increased after surgery in 5 cases, all returned to nearly normal state in about 1 year. No ureteral injury, dysuria, fecal incontinence and anastomotic leakage and other complications. Conclusion Laparoscopy TME + anal sphincter preserving surgery for low rectal cancer is safe and feasible, reflecting the advantages of minimally invasive surgery.