无瘤术用于直肠癌功能性扩大根治术对患者复发及生存率的影响

Observation on the follow-up recurrence and survival rate of no-tumor procedure applied in functional extending of the radical operation for rectal cancer

目的观察无瘤术用于直肠癌功能性扩大根治术对患者复发及生存率的影响。方法选择2011年4月至2013年9月于我院接受手术治疗的74例结直肠癌患者为研究对象。随机分为观察组和对照组,每组37例。两组均进行直肠癌功能性扩大根治术,观察组术中增加无瘤技术的使用。观察两组手术指标、术后恢复时间,术后6个月随访评估两组排尿功能及性功能,术后1年内随访了解两组并发症发生率、复发率、转移率及生存率。结果两组术中出血量、淋巴结清扫数目、术后排气时间、尿管拔除时间及住院时间均无明显差异(P>0.05),观察组手术时间明显长于对照组(P<0.05);两组术后6个月时排尿功能评估各等级例数相当,观察组勃起功能评分(3.05±0.59)分,较对照组(3.12±0.73)分无明显差异(P>0.05);术后1年内,两组术后感染、肠梗阻及尿潴留的比例相当(P>0.05),观察组切口种植发生率为2.70%,明显低于对照组16.22%(P<0.05);术后1年内,观察组复发率为5.41%,显著低于对照组21.62%,生存率89.19%,明显高于对照组67.57%(P<0.05)。结论无瘤术用于直肠癌功能性扩大根治术,可显著改善患者生存率,并降低复发,具有临床应用价值。

Objective To observe the effect of no-tumor procedure applied in functional extending of the radical operation for rectal cancer on recurrence and survival rate in patients.Methods74 cases of patients with colorectal cancer who underwent surgical treatment in our hospital between April 2011 and September 2013 were selected as the study objects and were randomized into the observation group and control group, 37 cases in each group. Both of the two groups were treated by functional extending of the radical operation for rectal cancer. The observation group was additionally treated with no-tumor procedure during operation. The operation indexes and postoperative recovery time of the two groups were observed. With 6 months of follow-up after operation, the urinary function and sexual function of the two groups were evaluated. 1 year of follow-up was performed to understand the incidence of complications, recurrence rate, metastasis rate and survival rate of the two groups.Results There was no significant difference in intraoperative bleeding volume, the number of cleaned lymph nodes, postoperative exhaust time, time of catheter removal and hospitalization time between the two groups（P〉0.05）. The operation time of the observation group was significantly longer than that of the control group（P〈0.05）; At 6 months after operation, the number of cases in different urinary function level was close. The erectile function score of the observation group was（3.05±0.59） points. Compared with that of the control group（3.12±0.73） points, there was no significant difference（P〈0.05）; In 1 year after operation, the proportions of postoperative infection, intestinal obstruction and urinary retention in the two groups were close（P〉0.05）. The incidence of incision implantation in the observation group（2.70%） was significantly lower than that in the control group（16.22%）（P〈0.05）;In 1 year after operation, the recurrence rate of the observation group（5.41%） was significantly lower than that in the control group（21.62%） while the survival rate（89.19%） was significantly higher than that in the control group（67.57%）（P〈0.05）.Conclusion To apply no-tumor procedure in functional extending of the radical operation for rectal cancer can significantly improve the survival rate and reduce the recurrence rate. It has clinical application value.