结直肠肛门外科2025，Vol.31Issue(6)：532-536,5.DOI:10.19668/j.cnki.issn1674-0491.2025.06.006
"双主刀"模式直肠系膜解剖分离技巧在低位直肠癌腹腔镜全直肠系膜切除术中的应用价值探讨
Exploring the application value of the"two-surgeon"mode mesorectal anatomical dissec-tion technique in laparoscopic total mesorectal excision for low rectal cancer
摘要
Abstract
Objectives To explore the application value of the"two-surgeon"mode mesorectal anatomical dissection tech-nique in laparoscopic total mesorectal excision(LaTME)for low rectal cancer.Methods A descriptive case series study was conducted.Clinicopathological data of 26 male patients with low rectal cancer who underwent LaTME using the"two-surgeon"mode at Affiliated Qingyuan Hospital of Guangzhou Medical University from January 2020 to February 2025 were retrospectively analyzed.During surgery,the assistant functioned as a functional assistant(i.e.,the second sur-geon)through the operating port above the pubic symphysis.Intraoperative and postoperative clinicopathological param-eters,as well as follow-up outcomes(including urinary function,erectile function,and local recurrence),were recorded.Results The median operative time was 215(200,230)min,median intraoperative blood loss was 10(5,20)mL,me-dian number of lymph nodes harvested was 15(12,17),median time to first postoperative flatus was 35(30,48)h,and median total hospital stay was 9(8,13)days.Postoperative complications occurred in 2 cases(including 1 surgical site infection and 1 pulmonary infection).Postoperative pathological examination showed no positive circumferential resec-tion margins or distal resection margins,and the mesorectum was intact in all 26 cases.No intraoperative or postopera-tive deaths occurred.At 6 months postoperatively,the median International Prostate Symptom Score for the 16 analyzed patients was 5(3,5),all indicating mild urinary dysfunction.The median 5-item version of the International Index of Erectile Function score for the 13 analyzed patients was 22.0(18.5,23.0),with 8 cases showing no erectile dysfunction and 5 cases showing mild erectile dysfunction.The median postoperative follow-up time was 53(31,68)months.En-hanced CT of the chest/abdomen and colonoscopy revealed no local recurrence.Conclusion In LaTME for low rectal can-cer,applying the"two-surgeon"mode for mesorectal anatomical dissection can provide a satisfactory surgical field and ef-fectively maintain local micro-tension,which is conducive to performing meticulous surgical maneuvers.This approach is safe,feasible,and demonstrates favorable short-term outcomes.关键词
低位直肠癌/全直肠系膜切除术/"双主刀"模式/手术疗效Key words
low rectal cancer/total mesorectal excision/"two-surgeon"model/surgical outcomes分类
医药卫生引用本文复制引用
曾兵,何天伦,元志龙,蔡灿锋.."双主刀"模式直肠系膜解剖分离技巧在低位直肠癌腹腔镜全直肠系膜切除术中的应用价值探讨[J].结直肠肛门外科,2025,31(6):532-536,5.基金项目
国家临床重点专科 （）
国家自然科学基金(81973858) （81973858）
广东省消化系统疾病临床医学研究中心项目(2020B1111170004) （2020B1111170004）
广东省自然科学基金(2019A1515011200) （2019A1515011200）
