發(fā)布時間：2018-04-18 18:55

  本文選題：直腸脫垂 + 改良直腸前切除術　； 參考：《腹腔鏡外科雜志》2016年11期

【摘要】：目的:對比分析腹腔鏡與開腹改良直腸前切除術治療成人重度直腸脫垂的臨床療效及安全性。方法:回顧分析2009~2015年采用腹腔鏡改良直腸前切除術治療的30例成人重度直腸脫垂患者的臨床資料,并與同期開腹手術治療的30例患者進行對比分析。結果:兩組手術均獲成功,手術切除標本長度平均(24.2±4.0)cm與(23.6±4.4)cm,兩組相比差異無統(tǒng)計學意義。術中出血量平均(85.5±24.1)ml與(181.7±44.2)ml,腸道功能恢復時間平均(2.3±1.8)d與(4.2±1.5)d,術后平均住院(7.7±1.1)d與(11.4±1.8)d,手術時間平均(170.0±11.8)min與(120.9±20.3)min,兩組相比差異有統(tǒng)計學意義。并發(fā)癥發(fā)生率分別為16.7%與46.7%,腔鏡組術后并發(fā)癥發(fā)生率低,兩組相比差異有統(tǒng)計學意義。術后平均隨訪(36.0±11.3)個月,兩組復發(fā)率差異無統(tǒng)計學意義。結論:腹腔鏡改良直腸前切除術治療成人重度直腸脫垂安全、可靠,可取得與開腹手術相同的效果,復發(fā)率低,具有明顯的微創(chuàng)優(yōu)勢,術后康復快,臨床療效較滿意。
[Abstract]:Objective: to compare the efficacy and safety of laparoscopic and open modified anterior rectal resection in the treatment of severe rectal prolapse in adults.Methods: the clinical data of 30 adult patients with severe rectal prolapse treated by Laparoscopic modified anterior rectal resection from 2009 to 2015 were retrospectively analyzed and compared with 30 patients who underwent open surgery at the same time.Results: the operation was successful in both groups. The average length of resected specimens was 24.2 鹵4.0)cm and 23.6 鹵4.4 cm respectively. There was no significant difference between the two groups.The average volume of bleeding during operation was 85.5 鹵24.1)ml and 181.7 鹵44.2? ml, the average recovery time of intestinal function was 2.3 鹵1.8 days and 4.2 鹵1.5? d, the average hospitalization time was 7.7 鹵1.1 days and 11.4 鹵1.8 minutes, and the average operation time was 170.0 鹵11.8)min and 120.9 鹵20.3min. the difference between the two groups was statistically significant.The incidence of complications was 16.7% and 46.7% respectively. The incidence of postoperative complications in the endoscopic group was lower than that in the two groups.The average follow-up time was 36.0 鹵11.3 months. There was no significant difference in recurrence rate between the two groups.Conclusion: Laparoscopic modified anterior rectal resection is safe and reliable in the treatment of severe rectal prolapse in adults. It can achieve the same effect as open surgery, with low recurrence rate, obvious minimally invasive advantage, quick postoperative recovery and satisfactory clinical effect.
【作者單位】： 邯鄲市中心醫(yī)院;
【分類號】：R657.19

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