吻合器保肛手术与Miles手术治疗老年低位直肠癌的疗效及生活质量分析

Comparison and analysis between stapling device application and Miles operation with low rectal cancer

目的 比较老年低位直肠癌患者采用吻合器保肛手术治疗与Miles 手术治疗的预后情况及短期并发症.方法回顾性分析98 例老年直肠癌患者的临床资料,其中行低位直肠癌吻合器保肛手术患者45 例（观察组）,行Miles 手术53 例（对照组）.比较术后并发症,肿瘤局部复发,远处转移、3 年生存率以及生活质量.结果 （ 1）观察组术后短期并发症高于对照组,但该组患者术后生活质量较高（P ＜ 0.05）.（2）随访11~40 个月,观察组与对照组生存率及肿瘤复发率差异无统计学意义（P ＞ 0.05）.结论 直肠癌手术以根治性切除为原则,但对于适合吻合器保肛治疗的患者,应首选保肛手术,提高患者术后的生活质量.

Objective To study the clinical effects of the anal conservative surgery（ACS） between stapling device application and Miles operation for the aged patients with low rectal cancer. Methods 98 patients with low rectal cancer were studied retrospectively. Based on different operation methods,the observation group contained 45 patient（stapling device application） and the control groups contained 53 patients （Miles operation）. Comparison was made between two groups in respects of post-operation complication,tumor recurrence,survival rate. Results （1）The complication rate in observation group were higher than the control group. But the observation group has higher life quality.（2）There were no obvious differences between two groups in tumor recurrence and survival rate. Conelusion Based on the radical excision treatment,ACS for the aged patients of low rectal cancer is eligible and could improve their quality of life.