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腹腔镜辅助下直肠外翻拖出式手术治疗直肠癌的效果观察

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  【摘要】 目的:探析腹腔鏡辅助下直肠外翻拖出式手术治疗直肠癌的疗效及安全性。方法:选取2015年5月-2017年5月本院收治的40例直肠癌患者。按照随机数字表法将其分为对照组和观察组,各20例。对照组行腹腔镜辅助下直肠前切除直肠癌根治术,观察组行腹腔镜辅助下直肠外翻拖出式手术。比较两组手术时间、术中出血量、术后2周及6个月内的日排便次数、肠功能恢复时间、住院时间、并发症发生率、复发率。结果:两组患者手术时间、术中出血量比较,差异均无统计学意义(P>0.05);观察组患者的术后日排便次数、肠功能恢复时间、住院时间均明显少于对照组,比较差异均有统计学意义(P<0.05);观察组患者并发症发生率为5.0%,低于对照组的30.0%(P<0.05);两组术后随访1年的复发率比较差异无统计学意义(P>0.05)。结论:腹腔镜辅助下直肠外翻拖出式手术治疗直肠癌的临床效果显著,可优化各项术后指标,术后恢复更好,并发症少,短期内复发率低,预后佳,故值得进一步推广应用。
   【关键词】 腹腔镜; 直肠外翻拖出式手术; 直肠癌
   【Abstract】 Objective:To explore the efficacy and safety of laparoscopic-assisted rectal eversion-out surgery for rectal cancer.Method:A total of 40 patients with rectal cancer admitted to our hospital from May 2015 to May 2017 were selected.According to the random number table method,they were divided into control group and observation group,20 cases in each group.The control group were treated with laparoscopic-assisted anterior rectal resection and radical resection of rectal cancer,and observation group were treated with laparoscopic-assisted rectal eversion-out surgery.The operation time,intraoperative bleeding volume,daily defecation times within 2 weeks and 6 months after operation,recovery time of intestinal function,hospitalization time,incidence of complications and recurrence rate between two groups were compared.Result:The operation time and intraoperative bleeding volume in two groups were compared,the differences were not statistically significant(P>0.05).The daily defecation times within 2 weeks and 6 months after operation,recovery time of intestinal function and hospitalization time in observation group were shorter than those of control group,the differences were statistically significant(P<0.05).The incidence of complications in observation group was 5.0%,which was lower than 30.0% in control group (P<0.05).The recurrence rate of one year follow-up in two groups was compared,the difference was not statistically significant(P>0.05).Conclusion:Laparoscopic-assisted rectal eversion-out surgery for rectal cancer has significant clinical effects,can optimize various postoperative indexes,improve postoperative recovery,have fewer complications,has a low recurrence rate in the short term,and has a good prognosis,so it is worth further promotion and application.
   【Key words】 Laparoscopy; Rectal eversion-out surgery; Rectal cancer
   First-author’s address:Yidu First People’s Hospital,Yidu 443300,China
   doi:10.3969/j.issn.1674-4985.2019.01.014    综上所述,腹腔镜辅助下直肠外翻拖出式手术治疗直肠癌的临床效果显著,可优化各项术后指标,术后恢复更好,并发症少,短期内复发率低,预后佳,值得进一步推广应用。
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  (收稿日期:2018-08-28) (本文编辑:董悦)
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