| 王吉胜，刘强，陈红兵.膜解剖引导下腹腔镜直肠癌根治术联合回肠末端预造瘘术在低位直肠癌患者中的应用研究[J].中国医药科学,2023,(8):7-10 基金项目:国家卫生健康委医药卫生科技发展研究中心课题（WA2021RW30）；甘肃省武威市市列科技计划项目（WW2101140） |
| 膜解剖引导下腹腔镜直肠癌根治术联合回肠末端预造瘘术在低位直肠癌患者中的应用研究 |
| Membrane anatomy-guided laparoscopic radical resection of rectal cancer plus terminal ileostomy in patients with low rectal cancer |
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| DOI： |
| 中文关键词: 膜解剖；腹腔镜直肠癌根治术；回肠末端造瘘术；低位直肠癌 |
| 英文关键词:Membrane anatomy; Laparoscopic radical resection of rectal cancer; Terminal ileostomy; Low rectal cancer |
| 作者 | 单位 | | 王吉胜，刘强，陈红兵 | 甘肃省武威肿瘤医院胃肠外科，甘肃武威 733000 |
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| 中文摘要: |
| [摘要] 目的 分析膜解剖引导下腹腔镜直肠癌根治术联合回肠末端造瘘术在低位直肠癌患者中的应用效果。 方法 选取甘肃省武威肿瘤医院于2021年12月至2022年5月收治低位直肠癌患者92例，按随机数表法分为研究组与对照组，每组各46例。两组均采用左下腹部膜解剖引导腹腔镜直肠癌根治术，对照组取右下腹部做切口行回肠末端造瘘术，研究组取左下腹部切口行回肠末端造瘘术，比较两组手术指标、术后胃肠功能恢复时间、住院时间及并发症情况。 结果 研究组手术时间、术中出血量、术后引流量低于对照组且肠鸣音恢复时间、首次排气时间、肛门恢复排气时间及住院时间均短于对照组（P < 0.05），两组患者并发症总发生率比较，差异无统计学意义（P > 0.05）。 结论 膜解剖引导下腹腔镜直肠癌根治术联合回肠末端造瘘术方案临床疗效好，左下腹部回肠末端预造瘘术手术时间更短，出血更少，肠道功能恢复更快，临床具有一定借鉴意义。 |
| 英文摘要: |
| [Abstract] Objective To analyze the efficacy of membrane anatomy-guided laparoscopic radical resection of rectal cancer (LRRRC) plus terminal ileostomy in patients with low rectal cancer. Methods A total of 92 patients with low rectal cancer admitted to Gansu Wuwei Tumour Hospital from December 2021 to May 2022 were selected and divided into a study group (n=46) and a control group (n=46) according to the random number table method. Both groups underwent laparoscopic radical resection of rectal cancer guided by left lower abdominal membrane dissection. The control group underwent ileostomy through an incision in the right lower abdomen, and the study group made an incision on the left lower abdomen for ileostomy at the end of the ileum. The surgical indexes, post-surgical recovery time of gastrointestinal function, hospital stay and the incidence of complications were compared between the two groups. Results The surgery duration, intra-surgical bleeding volume, post-surgical drainage in the study group were shorter/less than those in the control group, and the recovery time of bowel sounds, time of first exhaust, recovery time of anal exhaust and hospital stay were shorter than those in the control group (P < 0.05). There was no significant difference between the two groups in the total incidence of complications (P > 0.05). Conclusion The combination of membrane anatomy-guided LRRRC and terminal ileostomy shows good clinical efficacy, especially the selection of terminal ileostomy site in the left lower abdomen, which costs shorter surgery duration, causes less bleeding volume and shortens the recovery time of gastrointestinal function, providing some clinical significance. |
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