腹腔镜与开腹改良直肠前切除术治疗成人重度直肠脱垂的对比研究

发布时间：2018-04-18 18:55

本文选题：直肠脱垂 + 改良直肠前切除术　；参考：《腹腔镜外科杂志》2016年11期

【摘要】：目的:对比分析腹腔镜与开腹改良直肠前切除术治疗成人重度直肠脱垂的临床疗效及安全性。方法:回顾分析2009~2015年采用腹腔镜改良直肠前切除术治疗的30例成人重度直肠脱垂患者的临床资料,并与同期开腹手术治疗的30例患者进行对比分析。结果:两组手术均获成功,手术切除标本长度平均(24.2±4.0)cm与(23.6±4.4)cm,两组相比差异无统计学意义。术中出血量平均(85.5±24.1)ml与(181.7±44.2)ml,肠道功能恢复时间平均(2.3±1.8)d与(4.2±1.5)d,术后平均住院(7.7±1.1)d与(11.4±1.8)d,手术时间平均(170.0±11.8)min与(120.9±20.3)min,两组相比差异有统计学意义。并发症发生率分别为16.7%与46.7%,腔镜组术后并发症发生率低,两组相比差异有统计学意义。术后平均随访(36.0±11.3)个月,两组复发率差异无统计学意义。结论:腹腔镜改良直肠前切除术治疗成人重度直肠脱垂安全、可靠,可取得与开腹手术相同的效果,复发率低,具有明显的微创优势,术后康复快,临床疗效较满意。
[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 卤4.0)cm and 23.6 卤4.4 cm respectively. There was no significant difference between the two groups.The average volume of bleeding during operation was 85.5 卤24.1)ml and 181.7 卤44.2? ml, the average recovery time of intestinal function was 2.3 卤1.8 days and 4.2 卤1.5? d, the average hospitalization time was 7.7 卤1.1 days and 11.4 卤1.8 minutes, and the average operation time was 170.0 卤11.8)min and 120.9 卤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 卤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.
【作者单位】：邯郸市中心医院;
【分类号】：R657.19

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