摘要
目的研究以卫式线引导的保留邓氏筋膜全直肠系膜切除术的临床意义。方法回顾性分析2022年4月至2023年5月60例中低位男性直肠癌患者的临床资料。根据不同手术方案分为观察组(n=30例,接受腹腔镜下卫式线引导保留邓氏筋膜的全直肠系膜切除术)和传统组(n=30例,接受传统腹腔镜全直肠系膜切除术)。采用统计学软件SPSS 22.0处理数据。手术时间、术中出血量等符合正态分布的计量资料用(±s)表示,行独立样本t检验;术后并发症等计数资料用[例(%)]表示,采用χ^(2)检验或Fisher精确概率法。P<0.05表示差异具有统计学意义。结果观察组患者手术时间明显长于传统组,术中出血量明显少于传统组,肛门首次排气与术后下床活动时间明显短于传统组(P<0.05);两组患者术后并发症总发生率比较,观察组低于传统组(6.7%vs.16.7%),但差异无统计学意义(P>0.05);两组患者自由尿流量、排尿量较治疗前显著下降、残尿量显著升高(P<0.05),且观察组变化程度小于传统组(P<0.05);观察组患者术后12个月勃起功能障碍率、射精功能障碍率均显著低于传统组(P<0.05)。结论腹腔镜下以卫式线引导的保留邓氏筋膜的全直肠系膜切除术应用于中低位直肠癌男性患者,并发症总发生率低,且能显著降低对男性泌尿功能和性功能的影响,促进患者早期康复。
Objective To investigate the clinical significance of total mesorectal excision(TME)with preservation of Denonvilliers’fascia guided by Wei’s line.Methods A retrospective analysis was performed on the clinical data of 60 male patients with mid-low rectal cancer from April 2022 to May 2023.The patients were divided into the observation group(n=30,receiving laparoscopic TME with preservation of Denonvilliers’fascia guided by Wei’s line)and the traditional group(n=30,receiving traditional laparoscopic TME)according to different surgical protocols.Data were processed using SPSS 22.0 statistical software.Measurement data conforming to normal distribution(such as operation time and intraoperative blood loss)were expressed as(±s),and independent sample t tests were used;enumeration data(such as postoperative complications)were expressed as[cases(%)],andχ^(2) test or Fisher’s exact probability method was applied.P<0.05 was considered statistically significant.Results The operation time of the observation group was significantly longer than that of the traditional group,the intraoperative blood loss was significantly less,and the time to first anal exhaust and ambulation after surgery were significantly shorter(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the traditional group(6.7%vs.16.7%),but the difference was not statistically significant(P>0.05).The free urinary flow rate and urine volume of both groups significantly decreased,and residual urine volume significantly increased compared with those before treatment(P<0.05),and the degree of decline in the observation group was less than that in the traditional group(P<0.05).The incidence rates of erectile dysfunction and ejaculatory dysfunction at 12 months after surgery in the observation group were significantly lower than those in the traditional group(P<0.05).Conclusion Laparoscopic TME with preservation of Denonvilliers’fascia guided by Wei’s line for male patients with mid-low rectal cancer has a low total incidence of complications,can significantly reduce the impact on male urological and sexual functions,and promote early rehabilitation of patients.
作者
孔宪诚
沙粒
杜磊
刘岗
Kong Xiancheng;Sha Li;Du Lei;Liu Gang(Department of General Surgery,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)
出处
《中华普外科手术学杂志(电子版)》
2025年第5期523-526,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
上海市进一步加快中医药传承创新发展三年行动计划项目[ZY(2021-2023)-0201-02]。
关键词
直肠肿瘤
全直肠系膜切除术
腹腔镜
卫式线
邓氏筋膜
Rectal Neoplasms
Total Mesorectal Excision
Laparoscopes
Wei’Line
Denonvilliers Fascia
作者简介
通信作者:刘岗,Email:13301200251@163.com。
