中低位直肠癌行肠低位双吻合微创手术的效果研究

The operation result of laparoscopic low dual anastomosis for patients with middle and low rectal cancer

目的:探讨中低位直肠癌行肠低位双吻合微创手术的效果。方法:选择46例诊断为中低位直肠癌的患者行腹腔镜肠低位双吻合,38例中低位直肠癌患者行开腹肠低位双吻合,对比两组术中、术后情况及并发症等。术后随访1年,对比两组生存率。结果:腹腔镜组术中出血量、术后引流量、术后引流时间、肠鸣音出现时间、排气时间、进食时间及住院时间均明显少于开腹组,差异有统计学意义(P<0.05)。腹腔镜组吻合口漏、肠梗阻发生率明显低于开腹组,差异有统计学意义(P<0.05)。两组死亡原因及6个月、1年生存率相比差异均无统计学意义(P>0.05)。结论:中低位直肠癌患者行腹腔镜直肠低位双吻合手术具有较好的临床疗效,有效降低了吻合口漏及肠梗阻的发生率。

Objective： The aim of this study was to observe and explore the operation result of laparoscopic low dual anastomosis for patients with middle and low rectal cancer. Methods： Forty-six patients who were diagnosed as middle and low rectal cancer underwent laparoscopic low dual anastomosis and 38 patients of middle and low rectal cancer underwent open low dual anastomosis. The intraoperative and postoperative differences and complications were compared. The survival rate after 1 year of follow-up were compared.Results： The intraoperative blood loss,postoperative volume of drainage,drainage time,recovery time of gastrointestinal function,exhaust time,eating time and hospital stay in laparoscopic group were significantly less than those in laparotomy group,the differences were statistically significant（ P〈0. 05）. The incidence of anastomotic leakage,intestinal obstruction in laparoscopic group were significantly lower than those in laparotomy group,the differences were statistically significant（ P〈0. 05）. There were no differences in death reason or survival rate of 6 months,1 year（ P〉0. 05）. Conclusions： Laparoscopic low dual anastomosis has better clinical curative effect for patients with middle and low rectal cancer,and can effectively reduce the incidence of anastomotic leakage and intestinal obstruction.