腹腔镜经括约肌间切除术与Dixon术治疗超低位直肠癌对患者术后肛门功能恢复的影响

Effect of Laparoscopic Transsphincteric Intersphincteric Resection Versus Dixon's Procedure in the Treatment of Ultra-low Rectal Cancer on Patients'Postoperative Anal Function Recovery

目的:探讨腹腔镜经括约肌间切除术与直肠癌前切除(Dixon)术治疗超低位直肠癌对患者术后肛门功能恢复的影响。方法:选取2021年3月—2022年3月江陵县人民医院进行手术治疗的60例超低位直肠癌患者作为研究对象,按随机数表法将其分为对照组和腹腔镜组,每组各30例。对照组患者实施Dixon术治疗,腹腔镜组患者实施腹腔镜经括约肌间切除术治疗。比较两组患者手术相关指标、肛门直肠动力学指标、肛门功能、术后并发症发生情况以及预后情况。结果:腹腔镜组患者手术失血量少于对照组,手术后住院时间和第一次肛门排气时间短于对照组,差异有统计学意义(P<0.05)。手术后1个月,腹腔镜组患者肛门直肠动力学指标低于对照组,差异有统计学意义(P<0.05)。出院时、术后4个月、术后8个月,腹腔镜组患者肛门功能评分低于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜经括约肌间切除术对可降低术后的出血量,缩短术后住院时间和第一次肛门排气时间,促进术后肛门功能恢复。

Objective:To investigate the effect of laparoscopic transsphincteric intersphincteric resection versus anterior resection of the rectum(Dixon)in the treatment of ultralow rectal cancer on the patients'postoperative recovery of anal function.Method:60 cases of ultra-low rectal cancer patients who underwent surgical treatment in Jiangling County People's Hospital from March 2021 to March 2022 were selected as the study subjects,and they were divided into the control group and the laparoscopic group according to the method of random number table,with 30 cases in each group.Patients in the control group were treated with Dixon's operation,and patients in the laparoscopic group were treated with laparoscopic transsphincteric resection.Surgery-related indexes,anorectal kinetic indexes,anal function,occurrence of postoperative complications and prognosis were compared between the two groups.Result:Patients in the laparoscopic group had less surgical blood loss than those in the control group,and the postoperative hospitalization time and the time to the first anal evacuation were shorter than those in the control group,with statistically significant differences(P<0.05).1 month after surgery,the anorectal kinetic indexes of patients in the laparoscopic group were lower than those of the control group,and the difference was statistically significant(P<0.05).At the time of discharge,4 months postoperatively,and 8 months postoperatively,the anal function scores of the patients in the laparoscopic group were lower than those of the control group,and the difference was statistically significant(P<0.05).Conclusion:Laparoscopic transsphincteric intersphincteric resection pairs can reduce postoperative bleeding,shorten postoperative hospitalization and time to first anal voiding,and promote recovery of postoperative anal function.