目的

探讨腹腔镜直肠癌Dixon手术选择性应用超声刀和电钩的临床效果。

方法

回顾性分析2017年9月至2023年8月接受腹腔镜Dixon手术的直肠癌患者125例，根据手术解剖方式将患者分为两组，观察组65例术中选择性应用超声刀和电钩，对照组60例术中全程应用超声刀，比较两组患者手术相关指标及术后并发症。应用SPSS 22.0处理数据，计量资料采用（± s）表示，行独立样本t检验；计数资料采用［例（%）］表示，行χ²检验。P＜0.05为差异有统计学意义。

结果

观察组与对照组比较，手术时间差异有统计学意义（P＜0.05），患者术中失血量、术后3d腹腔引流总量、引流管拔除时间、尿管拔除时间、肠功能恢复时间及术后平均住院日差异无统计学意义（P＞0.05）。两组患者术后均未发生吻合口出血、吻合口漏及尿潴留。患者术后1年内吻合口狭窄发生率观察组为3.1%，对照组为3.3%，差异无统计学意义（P＞0.05）。

结论

腹腔镜直肠癌Dixon手术根据解剖部位及组织结构特点选择性应用超声刀和电钩，有利于加速手术进程，减少麻醉时间，降低并发症风险。

Objective

To investigate the clinical effect of selective application of ultrasonic knife and electric hook in laparoscopic Dixon surgery for rectal cancer.

Methods

A retrospective analysis was performed on 125 patients with rectal cancer who received laparoscopic Dixon surgery from September 2017 to August 2023.The patients were divided into two groups according to the surgical anatomy method: 65 patients in the observation group were selectively treated with ultrasonic knife and electric hook during the operation,and 60 patients in the control group were treated with ultrasonic knife throughout the operation.Operationrelated indicators and postoperative complications were compared between the two groups.SPSS 22.0 was used to process the data.Measurement data were expressed as (x±s) and independent sample t test was performed.The counting data is represented by［ cases (%)］ and tested by line χ².P＜0.05 was considered statistically significant.

Results

Compared with the control group, there were statistically significant differences in operation time (P＜0.05), but no statistically significant differences in intraoperative blood loss, postoperative 3d abdominal drainage, drainage tube removal time, urinary tube removal time, intestinal function recovery time and postoperative average hospital stay (P＞0.05).No postoperative anastomotic hemorrhage, anastomotic leakage and urinary retention occurred in both groups.The incidence of anastomotic stenosis within 1 year after surgery was 3.1% in the observation group and 3.3% in the control group, with no statistical significance (P＞0.05).

Conclusion

Laparoscopic Dixon surgery for rectal cancer selectively uses ultrasonic knife and electric hook according to the anatomical location and tissue structure characteristics, which is conducive to accelerating the surgical process, reducing the anesthesia time, and reducing the risk of complications.