65例腹腔镜下Parks直肠癌根治术的临床研究

The clinical rearch of laparoscopic Parks vesssed rectal cance in 65 patients

目的探讨腹腔镜下经肛门结肠肛管吻合直肠癌根治术(Parks术)的临床效果,提高患者术后生存质量。方法回顾性分析了2005年1月～2006年12月我院收治的直肠癌患者65例,采用腹腔镜下Parks直肠癌根治术作为研究组,另选择同期住院的直肠癌的患者63例,采用腹腔镜下经肛结肠拖出直肠癌根治术(Bacon's术)作为对照组。比较两组治疗后排便功能、局部复发率及5年生存率,同时比较两组患者生活质量评分(FACT)。结果研究组术后患者术后排便功能优良率和5年生存率分别为27.6%和76.9%;对照组患者术后排便功能优良率和5年生存率分别为9.5%和38.1%。两组比较差异有统计学意义(P<0.05)。研究组和对照组局部复发率分别为4.6%和6.3%,两组比较差异无统计学意义(P>0.05)。术后研究组患者FACT评分[(174.87±25.3)分]优于对照组[(101.82±23.6)分],两组比较差异有统计学意义(P<0.05)。结论腹腔镜下Parks直肠癌根治术为早期低位直肠癌患者保留肛门功能手术的一种,具有一定的临床意义。

Objective To explore the clinical effect of laparoscopic Parks vesssed rectal cance and improve the postoperative life quality of patients.Methods 65 patients with rectal cancer in our hospital from January 2008 to December 2010 were analysised.The laparoscopic Parks vesssed rectal cance were taken in the rearch group.63 patients with rectal cancer in the same period in our hospital were choosen as the contrlo group and the laparoscopic Bacon＇s vesssed rectal cance were taken in the control group.Complications after the treatment,defecating function,local recurrence rate and the 5-years survival rate of two groups were compared,and the quality of life scale（FACT） of the two group patients were compared.Results The defecating function rate of the rearch group after the surgery was 27.6% and 5-years survival rate was 76.9%,and the defecating function rate of the control group after the surgery was 9.5% and 5-years survival rate was 38.1%.There was a significant different between the two groups（P 0.05）.The local recurrence rate of the research group and the control group were 4.6%and 6.3%,there was no significant different between the two groups（P 0.05）.Compared with the control group,the FACT rating of the rearch group [（174.87±25.3） scores] was better than the control group[（101.82±23.6） scores],there was a significant different between the two groups（P 0.05）.Conclusion The advantages of laparoscopic of Parks Vesssed colorectal cancer is a kind of early low colorectal cancer patients to keep the anus function,there is certain clinical significance.