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目的:研究腹腔镜直肠癌根治术(Dixon)后吻合口血运状况及对吻合口愈合的影响。方法回顾性分析2008年8月至2015年4月开展的46例腹腔镜手术和57例开腹直肠癌根治术(Dixon)患者的临床资料,比较两组术中术后相关指标,并进行统计学分析。结果:腹腔镜组平均清扫淋巴结(13.5枚)相比开腹组(11.2枚),没有显著差异(p>0.05)。腹腔镜组边缘动脉搏动、小动脉喷血、近端肠管切缘涌血等反映吻合口血运状况的要优于开腹组(均p<0.01)。但吻合口漏的发生率(6.5%)与开腹组(8.8%)相比,差异无统计学意义(p>0.05)。结论:规范性腹腔镜直肠癌根治术在根部结扎肠系膜下动脉,有效保证了中央组淋巴结的清扫,吻合口血运较传统开腹手术差。但依靠边缘动脉血运可以满足吻合口愈合,相比开腹手术,没有增加吻合口漏的发生。
Objective: To study the anastomotic status and its effect on anastomotic healing after laparoscopic radical resection of rectal cancer (Dixon). Methods The clinical data of 46 cases of laparoscopic surgery and 57 cases of open rectal cancer radical mastectomy (Dixon) from August 2008 to April 2015 were retrospectively analyzed. The postoperative related indexes of the two groups were compared and statistically analyzed Analysis. Results: There was no significant difference between laparoscopic group (13.5) and open group (11.2) (p> 0.05). Laparoscopic group edge artery pulse, small artery spurting, proximal bowel resection marginal flow and so on reflecting the anastomotic conditions than the open group (all p <0.01). However, the incidence of anastomotic leakage (6.5%) was not significantly different from that of the open group (8.8%) (p> 0.05). Conclusion: Radical laparoscopic radical resection of the rectum in the roots of the inferior mesenteric artery ligation, effectively ensure the central lymph node dissection, anastomotic blood supply less than the traditional open surgery. However, relying on peripheral arterial blood flow to meet the anastomotic healing, compared with open surgery, did not increase the occurrence of anastomotic leakage.