[1]李腾龙叶贺鸣李俊蒙禹鹏飞张超闫旭丁大晃白军伟**.4K腹腔镜与传统高清腹腔镜下保留盆腔自主神经的低位直肠癌根治术的比较[J].中国微创外科杂志,2026,01(5):272-277.
　Li Tenglong,Ye Heming,Li Junmeng,et al.Comparison of 4K Laparoscopy and Traditional Laparoscopy for Pelvic Autonomic Nerve Preservation Radical Surgery of Low Rectal Cancer[J].Chinese Journal of Minimally Invasive Surgery,2026,01(5):272-277.
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4K腹腔镜与传统高清腹腔镜下保留盆腔自主神经的低位直肠癌根治术的比较()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2026年5期
页码:
272-277
栏目:
临床研究
出版日期:
2026-05-21

文章信息/Info

Title:
Comparison of 4K Laparoscopy and Traditional Laparoscopy for Pelvic Autonomic Nerve Preservation Radical Surgery of Low Rectal Cancer
作者:
李腾龙叶贺鸣李俊蒙禹鹏飞张超闫旭丁大晃白军伟**
(郑州大学省医临床医学院河南省人民医院胃肠外科，郑州450003)
Author(s):
Li Tenglong;  Ye Heming;  Li Junmeng;  et al.
Department of Gastrointestinal Surgery, Zhengzhou University Provincial Medical Clinical College, Henan Provincial People’s Hospital, Zhengzhou 450003, China
关键词:
直肠癌; 盆腔自主神经; 腹腔镜手术; 全直肠系膜切除术; 排尿功能; 性功能
Keywords:
Rectal cancer; Pelvic autonomic nerve; Laparoscopic surgery; Total mesorectal excision; Urinary function; Sexual function
文献标志码:
A
摘要:
目的探讨4K腹腔镜下保留盆腔自主神经(pelvic autonomic nerve preservation，PANP)的低位直肠癌根治术在男性患者中的应用价值。方法回顾性分析2020年4月~2025年4月113例男性低位直肠癌资料，均行PANP腹腔镜低位直肠癌根治术，其中59例使用4K超高清腹腔镜(4K组)，54例使用传统1080P高清腹腔镜(高清组)。2组年龄、体重指数、肿瘤距肛缘距离、肿瘤最大径、分化程度、美国麻醉医师协会分级、pTNM分期及腹部手术史差异均无显著性(P>0.05)。比较2组围手术期指标及术后6个月和12个月排尿、性功能。结果4K组术中出血量少于高清组［中位数46.1(四分位数36.9,51.7)ml vs. 78.1(71.1,83.1)ml］，手术时间［141.0(127.0,165.5)min vs. 181.0(167.0,189.8)min］、拔除尿管时间［1.8(15,2.5)d vs. 2.7(2.3,3.1)d］、术后住院时间［10.6(9.7,11.6)d vs. 12.5(11.3,13.7)d］均短于高清组(均P<0001)。2组切缘长度，淋巴结清扫数量，造口率，术后首次下床、进食、排气时间差异均无显著性(P>0.05)。术后6个月，4K组排尿功能优于高清组(P<0.05)，性功能差异无显著性(P>0.05)；术后12个月，2组排尿功能及性功能差异无显著性(P>0.05)。并发症：4K组切口感染1例、吻合口狭窄1例、下肢静脉血栓1例，高清组吻合口漏1例、切口感染2例、术后肠梗阻1例、下肢静脉血栓1例，差异无显著性(χ2=0.247，P=0.619)。结论4K腹腔镜下行PANP低位直肠癌根治术可减少术中出血，缩短手术及住院时间，改善术后排尿功能。
Abstract:
ObjectiveTo investigate the application value of 4K laparoscopic pelvic autonomic nerve preservation (PANP) radical surgery for low rectal cancer in male patients. MethodsThis study retrospectively included 113 male patients with low rectal cancer from April 2020 to April 2025, all of whom underwent PANP laparoscopic low rectal cancer radical surgery. Among them, 59 patients were operated under 4K ultrahighdefinition laparoscope (4K group), while 54 patients were operated under conventional 1080P highdefinition laparoscope (HD group). There were no statistically significant differences between the two groups in age, Body Mass Index, distance of the tumor from the anus, maximum tumor diameter, degree of differentiation, the American Society of Anesthesiologists (ASA) classification, pTNM stage, or history of abdominal surgery (P>0.05). Perioperative indicators as well as urinary and sexual functions at 6 months and 12 months postoperatively were compared between the two groups.ResultsThe intraoperative blood loss in the 4K group was less than that in the HD group ［46.1 (36.9, 51.7) ml vs. 78.1 (71.1, 83.1) ml］, and the operation time ［141.0 (127.0, 165.5) min vs. 181.0 (167.0, 189.8) min］, catheter removal time ［1.8 (1.5, 2.5) d vs. 2.7 (2.3, 3.1) d］, and postoperative hospital stay ［10.6 (9.7, 11.6) d vs. 12.5 (11.3, 13.7) d］ were all shorter than those in the HD group (all P<0.001). There were no statistically significant differences between the two groups in resection margin length, number of lymph nodes dissected, stoma rate, and time to first ambulation/feeding/flatus postoperatively (P>0.05). At 6 months postoperatively, urinary function in the 4K group was better than that in the HD group (P<0.05), while the difference in sexual function was not statistically significant (P>0.05). At 12 months postoperatively, there were no significant differences in urinary and sexual function between the two groups (P>0.05). The 4K group had 1 case of incision infection, 1 case of anastomotic stricture, and 1 case of lower limb venous thrombosis; the HD group had 1 case of anastomotic leakage, 2 cases of incision infection, 1 case of postoperative intestinal obstruction, and 1 case of lower limb venous thrombosis. The differences were not statistically significant (χ2=0.247, P=0.619).ConclusionPerforming PANP radical surgery for low rectal cancer under 4K laparoscope can reduce intraoperative bleeding, shorten surgery time and hospital stay, and improve postoperative urinary function.

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备注/Memo

备注/Memo:
基金项目：2024年河南省科技发展计划(242102311090)**通讯作者，Email：784855985@qq.com
更新日期/Last Update: 2026-05-21