低位直肠癌保肛术中单、双吻合器的疗效对比

Comparison of the therapeutic effect between single stapling technique and double stapling technique used in anus-preserving operation for low rectal cancer

目的:比较单吻合器技术(SST)与双吻合器技术(DST)在低位直肠癌保肛术中吻合的疗效和安全性。方法:回顾性分析2011年1月至2013年3月信阳市中心医院肿瘤外科收治的132例低位直肠癌的患者行保肛术治疗的病例资料,根据术中结肠、直肠吻合方式的不同,分为SST组与DST组,比较两组患者术中、术后指标及并发症发生率、局部复发率的情况。结果:两组患者术中出血量、住院总天数、局部复发率无统计学差异(P均>0.05)。SST组肿瘤下缘距齿状线较短、远端切缘长度较短[(1.84±0.58)cm vs(2.08±0.55)cm]、吻合口瘘发生率低[2.08%(1/48)vs 7.14%(6/84)],住院费用较低[(20340.29±7798.97)元vs(25476.29±7853.44)元],但手术时间较长[(126.85±38.21)min vs(110.13±35.67)min],差异均有统计学意义(P均<0.05)。结论:与DST组比较,在低位直肠癌保肛术中,SST组远端切缘长度较短,吻合口瘘发生率较低,住院费用较少,更值得临床推广。

Objective：To compare the efficacy and safety of single stapling technique （SST） and double stapling technique（DST） used in anus-preserving operation for low rectal cancer.Methods：The clinical data of 132 patients of Xinyang Cenral Hospital with low rectal cancer undergoing anus-preserving operation from January 2011 to March 2013 were analyzed retrospectively.The patients were divided into SST group and DST group by different intestinal anastomosis way in operation.Then,intraoperative and postoperative indexes,complication rate,recurrence rate of the two groups were compared.Results：There were no significant differences in intraoperative blood loss,total day of hospital stay and local recurrence rate （P 〉 0.05）.Compared with DST group,the distance from the dentate line to the edge of tumor,and the length of the distal surgical margin [（1.84 ± 0.58） cm vs （2.08 ± 0.55） cm] of SST group were shorter（P 〈 0.05）,anastomotic leakage rate[2.08% （1/48） vs 7.14% （6/84）] and hospitalization cost [（20340.29 ± 7798.97） yuan vs （25476.29 ± 7853.44） yuan] were lower （P 〈 0.05）.But operative time was longer [（126.85 ± 38.21） min vs （110.13 ± 35.67） min,P 〈 0.05].Conclusion：Compared with DST group,SST group results in shorter distal surgical margin,less anastomotic leakage rate,lower hospitalization costs in anus-preserving operation for low rectal cancer.