腹腔镜下 Miles 术乙状结肠造口治疗老年人直肠癌疗效观察

Observation of the effect of Miles laparoscopic sigmoid colostomy surgery for elderly patients with colorectal cancer

目的：探讨腹腔镜下Miles术乙状结肠造口方式治疗老年人直肠癌的疗效。方法选取78例行Miles术老年直肠癌患者的临床资料，根据手术方法不同分为观察组39例和对照组39例，观察组行腹腔镜下操作Miles术，对照组行开腹式Miles术。比较两组安全性、早期并发症情况以及疗效。结果观察组术后并发症发生率、手术6个月造口功能临床优良率分别为5．13％、66．67％，均优于对照组的38．46％、20.51％（χ2＝12．70、9．69，均P＜0．05）；观察组排便感优于对照组（χ2＝29．40，P＜0．05）；观察组患者生活质量的躯体功能方面评分明显优于对照组（t＝3．30，P＜0．05）。结论腹腔镜下Miles术乙状结肠造口治疗老年直肠癌较传统开腹手术疗效更好，在降低近远期并发症、提高患者生活质量方面有着明显的实际意义。

Objective To investigate the effect of Miles laparoscopic sigmoid colostomy surgery for elderly patients with colorectal cancer .Methods The clinical data of 78 elderly patients with colorectal cancer underwent surgery were chosen .According to the different operation method , they were randomly divided into the observation group and control group ,39 cases in each group .The observation group was treated with laparoscopic Miles ,and the control group underwent surgery for abdominal Miles .The safety,efficacy,early complications of the two groups were analyzed and compared .Results The incidence rate of postoperative complication , excellent rate of ostomy surgery 6 months after operation in the observation group were 5.13%, 66.67%, respectively, which were better than 38.46%,20.51%in the control group （χ2 =12.70,9.69,all P〈0.05）.The defecate feeling of the observation group was better than that of the control group （χ2 =29.40,P〈0.05）.The difference of patients＇quality of life and physical function between the two groups was statistically significant （t=3.30,P〈0.05）.Conclusion The clinical effect of laparoscopic sigmoid colostomy surgery Miles in the treatment of elderly patients with colorectal cancer is bet -ter than traditional open surgery ,it has obvious practical significance such as reducing the short and long term compli -cations and improving the quality of life of patients .