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目的:探讨直肠脱出技术在腹腔镜低位保肛术中的应用价值。方法:回顾分析2005年10月至2009年1月运用直肠脱出技术行腹腔镜低位直肠前切除术的20例低位直肠肿瘤病人的临床资料,探讨其手术操作步骤及术后恢复情况、肿瘤根治性效果和随访结果。结果:所有病例均未发生术中严重并发症和手术死亡,无中转开腹手术;平均手术时间为(122±80)min,术中平均出血(50±70)mL,病人术后平均排气时间、留置导尿管时间及术后住院天数分别为(2.2±1.1)d、(4.9±2.4)d和(11.0±4.2)d。每例病人的平均清扫淋巴结总数为(15±4)枚,肿瘤距下切缘平均距离为(2.2±1.1)cm。所有病人均获随访,中位随访时间19(2～36)个月,未发现局部复发和远处转移,排便功能恢复均较满意。结论:直肠脱出技术运用于腹腔镜低位直肠保肛术安全有效,可作为低位直肠肿瘤保肛术的有效技术。
Objective: To explore the value of rectal prolapse in laparoscopic anus preservation. Methods: The clinical data of 20 patients with low rectal tumor undergoing laparoscopic low rectal resection from October 2005 to January 2009 were analyzed retrospectively. The operative procedure, postoperative recovery, tumor radicality, Results and follow-up results. Results: No serious intraoperative complications and surgical death occurred in all cases. The mean operative time was (122 ± 80) min and mean intraoperative bleeding was (50 ± 70) mL. The average postoperative exhaust volume Time, indwelling catheter and postoperative hospital stay were (2.2 ± 1.1) days, (4.9 ± 2.4) days and (11.0 ± 4.2) days, respectively. The average number of lymph nodes dissected per patient was (15 ± 4), and the average distance from the lower margin to the tumor was (2.2 ± 1.1) cm. All patients were followed up for a median follow-up of 19 months (range 2 to 36) months. No local recurrence or distant metastasis was found, and defecation recovery was satisfactory. Conclusion: The technique of rectal prolapse is a safe and effective method for laparoscopic low rectal anal sphincter preservation. It can be used as an effective technique for anal sphincter preservation in low rectal tumors.