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目的:探讨腹腔镜下行直肠全系膜切除术(TME)联合保留骨盆自主神经的直肠癌根治术(PANP)手术治疗男性直肠癌的临床价值及手术技巧,为男性直肠癌的临床治疗提供更多的参考依据。方法:回顾性分析我院收治的81例男性直肠癌患者的临床资料,将其中41例采取腹腔镜下保留盆腔自主神经全直肠系膜切除术的患者设为观察组,将40例开腹下行保留盆腔自主神经全直肠系膜切除术患者设为对照组,比较两组患者的手术相关指标、肿瘤相关指标、性功能、排尿功能障碍及术后局部复发情况。结果:1观察组患者的术中出血量、术后肠功能恢复时间、术后恢复饮食时间和术后下床活动时间明显少于或短于对照组(P<0.05),全程手术时间长于对照组(P<0.05),两组术后并发症的发生率比较无显著性差异(P>0.05);2术后,随访患者1年,观察组患者勃起功能障碍、射精功能和排尿功能障碍的发生率均明显低于对照组(P<0.05);两组患者1年后局部复发率比较无明显差异(P>0.05)。结论:腹腔镜下实施TME+PANP手术治疗男性直肠癌可在根治的基础上,降低对患者排尿和性功能的影响,值得在临床进一步推广。
Objective: To investigate the clinical value and surgical skills of laparoscopic radical total mesorectal excision (TME) and pelvic autonomic nerve rectal cancer radical surgery (PANP) in the treatment of male rectal cancer and to provide more information for the clinical treatment of male rectal cancer The reference basis. Methods: The clinical data of 81 male patients with rectal cancer treated in our hospital were retrospectively analyzed. Among them, 41 patients undergoing laparoscopic total mesorectal excision with pelvic autonomic nerve were treated as observation group and 40 underwent open laparotomy Patients with pelvic autonomic mesial mesorectal excision were enrolled as control group. Surgical related indicators, tumor related indicators, sexual function, urinary dysfunction and postoperative local recurrence were compared between the two groups. Results: 1 The observation group patients with intraoperative bleeding, intestinal function recovery time, postoperative recovery diet and postoperative ambulation time was significantly shorter than or shorter than the control group (P <0.05), the entire operation time longer than the control (P <0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P> 0.05). After 2 years of follow-up, the patients were followed up for 1 year. The erectile dysfunction, ejaculation function and voiding dysfunction (P <0.05). There was no significant difference in the local recurrence rate between two groups after one year (P> 0.05). Conclusions: Laparoscopic treatment of male rectal cancer with TME + PANP can reduce the influence of urination and sexual function on the basis of radical treatment, which is worth further promotion in clinic.