本文關(guān)鍵詞： 腹腔鏡 直腸癌 傳統(tǒng)開(kāi)腹 病例對(duì)照研究　出處：《昆明醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：[目的]評(píng)價(jià)腹腔鏡直腸癌根治術(shù)的臨床應(yīng)用價(jià)值,療效及對(duì)患者術(shù)后生活質(zhì)量的影響。[方法]回顧分析昆明醫(yī)科大學(xué)第二附屬醫(yī)院胃腸外科自2009年1月至2013年1月手術(shù)病人中81例直腸癌患者的臨床資料,其中41例行腹腔鏡直腸癌根治術(shù)(28例行Dixon手術(shù),13例行Miles手術(shù)),40例行開(kāi)腹直腸癌根治術(shù)(Dixon手術(shù)27例、Miles手術(shù)13例),對(duì)比分析兩組患者患者的淋巴結(jié)清除數(shù),術(shù)后并發(fā)癥、手術(shù)時(shí)間、直腸全系膜切除情況、出血量、胃腸功能恢復(fù)時(shí)間、下床活動(dòng)時(shí)間、排尿功能恢復(fù)情況、住院時(shí)間及術(shù)后隨訪結(jié)果。[結(jié)果]81例直腸癌根治術(shù)均獲成功,腹腔鏡組無(wú)一例中轉(zhuǎn)開(kāi)腹,腹腔鏡組與開(kāi)腹組一般資料差異無(wú)顯著性。腹腔鏡組與開(kāi)腹組的平均手術(shù)時(shí)間分別為212.35min和160.23 min,有顯著差異(P0.01),但隨著例數(shù)的增加腹腔鏡手術(shù)的時(shí)間呈明顯下降趨勢(shì),后15例病人的平均手術(shù)時(shí)間為176.52 min,與開(kāi)腹組比較無(wú)顯著差異(P0.05)。術(shù)中出血量、直腸系膜切除質(zhì)量腹腔鏡組顯著優(yōu)于開(kāi)腹組,腹腔鏡組住院時(shí)間明顯短于開(kāi)腹組,腹腔鏡組術(shù)后下床活動(dòng)時(shí)間、胃腸功能恢復(fù)及排尿功能恢復(fù)時(shí)間明顯早于開(kāi)腹組,保肛率、淋巴結(jié)清除數(shù)量、術(shù)后兩年生存率兩組差異無(wú)統(tǒng)計(jì)學(xué)意義。[結(jié)論]腹腔鏡直腸癌根治術(shù)微創(chuàng)、安全、有效,并且視野清晰,解剖層次清楚,操作方便,患者恢復(fù)快。
[Abstract]:[Objective] to evaluate the clinical value, curative effect and quality of life of laparoscopic radical resection of rectal cancer. [Methods the clinical data of 81 patients with rectal cancer in the second affiliated Hospital of Kunming Medical University from January 2009 to January 2013 were analyzed retrospectively. Among them 41 cases underwent laparoscopic radical resection of rectal cancer 28 cases underwent Dixon operation 13 cases underwent Miles operation and 40 cases underwent radical resection of rectal cancer. The number of lymph node clearance, postoperative complications, operative time, total mesorectal excision, bleeding volume and recovery time of gastrointestinal function were compared and analyzed in 13 cases of Miles operation. The time of getting out of bed, the recovery of urination function, the time of hospitalization and the results of postoperative follow-up. [Results] all the 81 cases of rectal cancer were successfully operated, and none of the cases in the laparoscopic group was converted to open operation. There was no significant difference in general data between the laparoscopic group and the open group. The mean operative time of the laparoscopic group and the open group were 212.35 and 160.23 min, respectively. There was a significant difference (P 0.01), but with the increase of the number of cases, the time of laparoscopic surgery decreased significantly. The average operative time of the latter 15 patients was 176.52 min. There was no significant difference between the laparoscopy group and the open group (P 0.05). The amount of blood lost during the operation, the quality of mesorectal excision in the laparoscopic group was significantly better than that in the open group, and the hospital stay in the laparoscopic group was significantly shorter than that in the open group. There was no significant difference between the laparoscopy group and the laparotomy group in the time of getting out of bed, the recovery of gastrointestinal function and urination function, the anus preserving rate, the number of lymph node clearance, and the two year survival rate of the two groups. [Conclusion Laparoscopic radical resection of rectal cancer is minimally invasive, safe, effective, with clear visual field, clear anatomical level, convenient operation and quick recovery.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R735.37

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 閆鴻濤;李國(guó)新;余江;雷尚通;薛琪;甄莉;;腹腔鏡與開(kāi)腹全直腸系膜切除術(shù)后男性泌尿與性功能障礙的比較研究[J];南方醫(yī)科大學(xué)學(xué)報(bào);2006年09期

2 賈光偉;;直腸癌保留盆腔植物神經(jīng)根治術(shù)與傳統(tǒng)根治術(shù)的臨床療效比較[J];醫(yī)藥論壇雜志;2009年22期

3 樊丁才;;腹腔鏡直腸癌根治術(shù)64例遠(yuǎn)期療效分析[J];海南醫(yī)學(xué);2012年14期

4 向德雨;胡侃;秦章祿;郭朝陽(yáng);周興艦;朱融慧;;腹腔鏡與開(kāi)腹直腸癌根治術(shù)對(duì)術(shù)后控便功能的影響[J];實(shí)用臨床醫(yī)學(xué);2014年08期

5 秦光遠(yuǎn);左朝暉;姚敦武;陳光譜;唐衛(wèi);;腹腔鏡直腸癌手術(shù)與傳統(tǒng)開(kāi)腹直腸癌手術(shù)的療效比較[J];臨床和實(shí)驗(yàn)醫(yī)學(xué)雜志;2011年06期

6 吳澤宇;盧曉裕;杜嘉林;趙剛;王志度;林鋒;彭林;;低位直腸癌腹腔鏡與開(kāi)腹根治術(shù)的療效比較[J];實(shí)用醫(yī)學(xué)雜志;2012年09期

7 甄亞男;徐忠法;李增軍;孫燕來(lái);韓建軍;王斌;;結(jié)直腸釘式吻合術(shù)后排便功能的評(píng)價(jià)[J];中華臨床醫(yī)師雜志(電子版);2011年07期

8 Ming-Xin Pan;Zhi-Wei Liang;Yuan Cheng;Ze-Sheng Jiang;Xiao-Ping Xu;Kang-Hua Wang;Hai-Yan Liu;Yi Gao;;Learning curve of transumbilical suture-suspension single-incision laparoscopic cholecystectomy[J];World Journal of Gastroenterology;2013年29期

9 劉瑞;張陽(yáng)德;宋士鵬;;腹腔鏡直腸癌根治術(shù)中保護(hù)盆腔植物神經(jīng)的應(yīng)用[J];中國(guó)內(nèi)鏡雜志;2013年08期

10 熊懿;;腹腔鏡直腸癌根治術(shù)與剖腹手術(shù)比較的研究[J];醫(yī)學(xué)綜述;2014年01期

相關(guān)碩士學(xué)位論文 前1條

1 王愷;腹腔鏡直腸癌根治術(shù)與開(kāi)腹手術(shù)患者術(shù)后生活質(zhì)量對(duì)比分析[D];青島大學(xué);2010年

，

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