腹腔镜与开腹下保留盆腔自主神经全直肠系膜切除术治疗直肠癌的效果比较

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Abstract Objective To compare the clinical effect of laparoscopic and laparotomic total mesorectal excision (TME)with pelvic autonomic nerve-preserving (PANP) in the treatment of rectal cancer.Methods A total of seventy-six patients with rectal cancer who were treated in the First People′s Hospital of Jiujiang City，Jiangxi Province from November 2016 to December 2018 were selected as the research objects and divided into the observation group and the control group according to the random number table method，with 38 cases in each group.Patients in the observation group received TME treatment with PANP under laparoscope，and patients in the control group received TME treatment with PANP under open surgery.The perioperative indicators，voiding function，the total incidence of sexual dysfunction and prognosis condition were compared between the two groups.Results The intraoperative blood loss ([103.57±22.06]mL)and the residual urine volume ([15.23±4.97]mL) of the observation group were lower than those of the control group([178.79±32.64]，[22.51±6.14]mL)，and the differences were statistically significant (P＜0.05).The operation time of the observation group ([175.34±42.18]min) was longer than that of the control group ([138.52±36.27]min)，and the difference was statistically significant (P＜0.05).The time of exhaust ([2.64±1.20]d)，hospital stay ([6.17±1.25]d)，and time of catheter removal ([2.54±1.38]d) in the observation group were shorter than those in the control group ([3.59±1.42]，[11.21±2.03]，[3.36±1.42]d)，and the differences were statistically significant (P＜0.05).The free urine flow rate ([26.97±5.28]mL/s) of the observation group was higher than that of the control group ([20.63±6.24]mL/s)，and the difference was statistically significant (P＜0.05).The incidence of ejaculation disorder and erectile dysfunction in the observation group (10.53%，5.79%) were lower than those in the control group (34.21%，36.84%)，and the differences were statistically significant (P＜0.05).There were no statistically significant differences in amount of lymph node dissection，incidence of urination disorder，recurrence rate，and metastasis rate between the two groups (P＞0.05).Conclusion For patients with rectal cancer，laparoscopic TME treatment with PANP has little damage and a definite radical cure effect，which can shorten the hospital stay，and improve voiding and sexual function.

Key words： Rectal cancer Laparoscopy Total mesorectal resection Pelvic autonomic nerve-preserving Voiding function

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	XIA Lv-chi
	WAN Yan-hua
	WANG Chuan-wen

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XIA Lv-chi,WAN Yan-hua,WANG Chuan-wen. Effect comparison of the laparoscopic and laparotomic total mesorectal excision with pelvic autonomic nerve-preserving in the treatment of rectal cancer[J]. 中国当代医药, 2020, 27(33): 90-93.

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https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2020/V27/I33/90

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