单孔加一孔腹腔镜手术在直肠癌治疗中应用的初步研究

doi:10.16139/j.1007-9610.2019.01.014

摘要/Abstract

摘要： 目的: 研究单孔加一孔腹腔镜手术在直肠癌根治术中的可行性、安全性、肿瘤根治程度、近期疗效以及操作优势。方法: 回顾性分析2013年9月至2018年1月间,在我科接受单孔加一孔腹腔镜直肠癌根治术20例病人的临床资料。另从采用单孔腹腔镜手术的直肠癌病人（n=62）中按1∶1的比例进行倾向性评分匹配,选出20例作为对照组。倾向性评分匹配因素包括年龄、性别、体质量指数（body mass index, BMI）、美国麻醉协会分级（≤2/>2）和 TNM（0~Ⅰ/Ⅱ/Ⅲ）分期。分析两组的临床资料以及手术结果。结果: 两组在手术时间、术中出血量、肿瘤大小、淋巴结清扫数、切口长度以及术后住院时间上,均无统计学差异。肿瘤距肛缘的距离上在两组间有统计学差异（P<0.05）。单孔加一孔组的中位随访时间为24.5个月,对照组为26.5个月。两组均无肿瘤复发。结论: 单孔加一孔腹腔镜直肠癌根治术可行和安全,可用于治疗距肛缘更近的直肠癌。

关键词: 单孔加一孔腹腔镜, 直肠癌, 单孔腹腔镜手术

Abstract: Objective To assess feasibility and safety of single-incision plus one laparoscopic surgery (SILS+1) in radical treatment of rectal cancer combined with analysis of short-term clinical and oncological outcomes. Methods Clinical data were studied retrospectively with 20 patients who underwent radical rectal cancer resection through SILS+1 from September 2013 to January 2018 in our department. A propensity score matching approach was used on pooled the data of 62 cases with single-incision laparoscopic surgery of rectal cancer at a radio of 1∶1 as control group of 20 cases after matching the demographic information of the patients and body mass index, American Society of Anesthesiologists score (≤2/>2) and TNM (0-Ⅰ/Ⅱ/Ⅲ) stage. Clinical data and operative results were analyzed between SILS+1 group and control group. Results No significant differences were observed in operative time, blood loss, tumor size, retrieved lymph node, length of incision, postoperative hospital stay between SILS+1 group and control group. However, SILS+1 group showed significantly shorter distance of rectal cancer from the anal verge (P<0.05). The median follow-up period was 24.5 months in SILS+1 group and 26.5 months in control group. There was no recurrent case in both groups. Conclusions SILS+1 for rectal cancer is feasible and safe, and can be used to treat rectal cancer more near from the anal verge.

Key words: Single-incision plus one laparoscopic surgery, Rectal cancer, Single-incision laparoscopic surgery

中图分类号:

R735.3⁺7

李军, 李佑, 施毅卿, 刘坤, 蒋奕玫, 宋子甲, 赵任. 单孔加一孔腹腔镜手术在直肠癌治疗中应用的初步研究[J]. 外科理论与实践, 2019, 24(01): 65-69.

LI Jun, LI You, SHI Yiqing, LIU Kun, JIANG Yimei, SONG Zijia, ZHAO Ren. Single-incision plus one laparoscopic surgery in treatment of rectal cancer: a preliminary study[J]. Journal of Surgery Concepts & Practice, 2019, 24(01): 65-69.

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