摘要
目的:比较腹腔镜与开腹全结直肠切除-回肠储袋肛管吻合术(TPC-IPAA)治疗男性家族性腺瘤性息肉病(FAP)患者的效果。方法:回顾性分析2019年6月至2021年6月该院收治的80例男性FAP患者的临床资料,按照治疗方式不同将其分为观察组和对照组各40例。观察组行腹腔镜TPC-IPAA治疗,对照组行开腹TPC-IPAA治疗,比较两组围术期指标(手术时间、术中出血量、最大切口长度、首次进食时间、住院时间)水平,术后1、3个月排尿功能、性功能(勃起功能、射精功能)Ⅰ级占比率,以及并发症发生率。结果:观察组手术时间长于对照组,术中出血量少于对照组,最大切口长度、首次进食时间、住院时间均短于对照组,差异有统计学意义(P<0.05);术后1个月,观察组排尿功能、勃起功能、射精功能Ⅰ级占比率均高于对照组,术后3个月,两组排尿功能、勃起功能、射精功能Ⅰ级占比率均高于术后1个月,且观察组高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为7.50%(3/40),低于对照组的27.50%(11/40),差异有统计学意义(P<0.05)。结论:腹腔镜TPC-IPAA治疗男性FAP患者可减少术中出血量,缩短最大切口长度、首次进食时间和住院时间,提高排尿功能和性功能Ⅰ级占比率,以及降低并发症发生率,效果优于开腹TPC-IPAA,但需延长手术时间。
Objective:To compare effects of laparoscopic and open total colorectal resection-ileal pouch anal anastomosis(TPC-IPAA)in treatment of male patients with familial adenomatous polyposis(FAP).Methods:The clinical data of 80 male FAP patients admitted to the hospital from June 2019 to June 2021 were retrospectively analyzed.They were divided into observation group and control group according to different treatment methods,40 cases in each.The observation group was treated with laparoscopic TPC-IPAA,while the control group was treated with open TPC-IPAA.The perioperative indicator levels(operation time,intraoperative blood loss,maximum incision length,the first feeding time,hospitalization time),the proportion of grade I urinary function 1 and 3 months after the surgery,the proportion of grade I sexual function(erectile function,ejaculation function),and the incidence of complications were compared between the two groups.Results:The operation time of the observation group was longer than that of the control group;the intraoperative blood loss less than the control group;the maximum incision length,the first feeding time and the hospitalization time were shorter than those in the control group;and the differences were statistically significant(P<0.05).1 month after the surgery,the proportion of grade I urination function,erectile function and ejaculation function in the observation group was higher than that in the control group;3 months after the surgery,the proportions of grade I of urinary function,erectile function and ejaculation function in the two groups were higher than those 1 month after the surgery,and that of the observation group was higher than that of the control group;and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 7.50%(3/40),which was lower than 27.50%(11/40)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Laparoscopic TPC-IPAA in the treatment of the male FAP patients can reduce the intraoperative blood loss,shorten the maximum incision length,the first feeding time and the hospitalization time,improve the proportion of grade I urinary function and sexual function,and reduce the incidence of complications.Moreover,it is superior to open TPC-IPAA,but the operation time needs to be prolonged.
作者
王友志
WANG Youzhi(Emergency Department of the Central Hospital of Jiamusi City,Jiamusi 154002 Heilongjiang,China)
出处
《中国民康医学》
2023年第7期136-138,142,共4页
Medical Journal of Chinese People’s Health
关键词
家族性腺瘤性息肉病
腹腔镜
开腹
全结直肠切除-回肠储袋肛管吻合术
排尿功能
性功能
并发症
Familial adenomatous polyposis
Laparoscope
Open abdomen
Total colorectal resection-ileal pouch anal anastomosis
Urinary function
Sexual function
Complication
