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目的探讨“dog ear”内陷式吻合在腹腔镜下直肠低位前切除吻合中的临床应用价值。方法回顾性分析2015年1月至2016年5月徐州市中心医院胃肠外科收治的18例行腹腔镜手术治疗的直肠癌病人临床资料,均采用“dog ear”内陷式吻合技术,观察并分析术后疗效。结果 18例病人均成功实施腹腔镜下两端角内陷式吻合术,无中转开放手术病例。手术时间150(120~180)min。术后无吻合口漏病例,1例病人术后发生吻合口出血。术中均未行预防性造口。术后3个月时随访病人平均排便次数(3.6±1.3)次/d。病人术后总体生活质量评价(GQL)为(92.8±12.1)分。结论腹腔镜“dog ear”内陷式吻合在直肠癌手术中安全可行,消除了因“dog ear”存在所造成的潜在吻合口漏风险。
Objective To investigate the clinical value of “dog ear” retraction anastomosis in laparoscopic anterior resection and anastomosis of the rectum. Methods The clinical data of 18 patients undergoing laparoscopic surgery for rectal cancer admitted to Department of Gastrointestinal Surgery, Central Hospital of Xuzhou from January 2015 to May 2016 were retrospectively analyzed. The “dog ear” Observation and analysis of postoperative efficacy. Results All 18 patients underwent laparoscopic anastomosis of both ends and no open surgery. Operation time 150 (120 ~ 180) min. No cases of anastomotic leakage after surgery, anastomotic bleeding occurred in 1 patient. No intraoperative preventive ostomy. At 3 months after surgery, the average number of defecations was 3.6 ± 1.3 times / d. The postoperative overall quality of life (GQL) was (92.8 ± 12.1) points. Conclusions Laparoscopic “dog ear” retraction anastomosis is safe and feasible in rectal cancer surgery, eliminating the potential risk of anastomotic leakage due to the presence of “dog ear”.