| 张占东 孔烨 姬社青 张 斌 王金榜 马 飞 马二民 刘 洪兴 花亚伟.腹腔镜下行 TME 联合 PANP 手术治疗男性直肠癌的临床研究[J].,2015,15(5):892-896 |
| 腹腔镜下行 TME 联合 PANP 手术治疗男性直肠癌的临床研究 |
| Clinical Research on the Application of Total Mesorectal Excision withPelvic Autonomic Nerve Preservation under the Laparoscope for MalePatients with Rectal Cancer |
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| 中文关键词: 直肠癌 保留盆腔自主神经 全系膜切除术 腹腔镜 |
| 英文关键词: Rectal cancer Pelvic Autonomic Nerve Preservation Total Mesorectal Excision Peritoneoscope |
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| 中文摘要: |
| 目的： 探讨腹腔镜下行直肠全系膜切除术(TME)联合保留骨盆自主神经的直肠癌根治术(PANP)手术治疗 男 性直肠癌的临
床价值及手术技巧，为男 性直肠癌的临床治疗 提供更多的参考依据。 方法： 回顾性分析我院收治的 81 例 男性直肠癌患者的临床
资料， 将其中 41 例 采取腹腔镜下保留盆腔自主神经全直肠系膜切除术的患者设为观察组， 将 40 例 开腹下行保留盆腔自主神经
全直肠系膜切除术患者设为对照组， 比较两组患者的手术相关指标、肿瘤相关指标、性功能、排尿功能障碍及术后局部复发情况。
结果： ① 观察组患者的术中出 血量、术后肠功能恢复时间 、术后恢复饮食时间 和术后下床活动时间 明显少于或短于对照组(P<0.
05)， 全程手术时间长于对照组(P<0.05)， 两组术后并发症的发生率比较无显著性差异(P>0.05)； ② 术后，随访患者 1 年， 观察组患者
勃起功能障碍、射精功能和排尿功能障碍的发生率均明显低于对照组(P<0.05)； 两组患者 1 年后局部复发率比较无明 显差异(P>0.
05)。 结论： 腹腔镜下实施 TME+PANP 手术治疗 男性直肠癌可在根治的基础上， 降低对患者排尿和性功能的影响， 值得在临床进
一步推广。 |
| 英文摘要: |
| Objective:To investigate the clinical application value and operative skills of conducting total mesorectal excision
(TME) with pelvic autonomic nerve preservation (PANP) under the laparoscope for male patients with rectal cancer, and provide references for the clinical treatment of rectal cancer.Methods:The clinical data of 92 cases of male rectal carcinoma patients admitted in our
hospital were retrospectively analyzed. According to the operation method, the patients were divided into 2 groups, in which 47 cases
treat- ed by TME and PANP under the laparoscope were considered as the observation group. And 45 cases treated by TME and PANP
under the laparotomy were considered as the control group. The operation-related index, tumour-related index, sexual function, urination
dysfunction and postoperative local recurrence were compared between the two groups.Results:① The intraoperative bleeding amount,
recovery time ofpostoperative intestines functions, time ofpostoperative recovery of eating and drinking, along with postoperative activity
time of the patients of the observation group were evidently lower or shorten than those of the control group (P<0.05). While the whole
operation time of observation group was longer than that of control group (P<0.05). No evident difference was found in the incidence of
postoperative complications between the two groups (P>0.05). ② After 1 -year postoperative follow-up visit, the incidence rates of erectile
dysfunction, ejaculation dysfunction and urination dysfunction of observation group were all significantly higher than those of control
group (P<0.05), no significant difference was found in the local recurrence rate one year after the operation (P>0.05).Conclusion:TME
with PANP under the laparoscope was beneficial for the radical resection of rectal carcinoma, which reduced the influence on urination
and sexual function of male patients with rectal cancer and worthy of further promotion. |
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