摘要
目的探讨腹腔镜下无腹部切口直肠癌切除经肛门外翻拖出吻合术在低位直肠癌中的临床应用价值。方法回顾性分析2012年1月至2014年7月收治的低位直肠癌患者80例,分为两组,无腹部切口组40例,实施无腹部切口腹腔镜下直肠外翻术,对照组40例,行腹腔镜辅助腹部切口治疗。比较两组手术相关情况、手术前后焦虑抑郁心理、术后3个月生活质量;2年生存情况分析使用Life Tables分析。结果无腹部切口组术中出血、手术时间均小于对照组(P<0.05);术后(具体时间)两组焦虑与抑郁评分均显著优于术前(P<0.05),术后无腹部切口组焦虑与抑郁评分低于对照组(P<0.05),生活质量总分显著高于对照组(P<0.05),发生吻合口漏、肠梗阻、出血及伤口感染的总并发症发生率显著低于对照组(P<0.05),1~2年生存率均高于对照组。结论腹腔镜下无腹部切口直肠癌切除经肛门外翻拖出吻合术能显著缩短手术时间,减少术中出血,保证患者术后腹部美观,同时缓解患者焦虑抑郁心理,减少手术并发症,提高术后生活质量,提高术后生存率。
Objective laparoscopic rectal eversion without abdominal incision Clinical Value of colorectal cancer in the low. Methods A retrospective study of 80 patients with low rectal cancer from January 2012 to July 2014 was performed. The patients were divided into two groups. No abdominal incision group (40 cases) underwent laparoscopic radical resection without abdominal incision. The control group (40 cases ) received laparoscopic abdominal incision. The operation related conditions, anxiety and depression before and after operation, and quality of life after 3 months were compared between the two groups. 2 year survival analysis was performed using Life Tables analysis. Results The ntraoperative bleeding, operation time, postoperative abdominal incision length in the no abdominal incision group were less than control group (P 〈 0.05 ), operative time shorter than the control group ( P 〈 0.05 ), postoperative abdominal incision length is less than the control group ( P 〈 0.05 ) , the two groups after intervention anxiety and depression scores were significantly better than before the intervention (P 〈 0.05 ), after the intervention in the observation group anxiety and depression scores than the control group ( P 〈 0.05 ) , quality of life out of the observation group was significantly higher ( P 〈 0.05 ), the observation group occurs anastomotic leak, bowel obstruction, bleeding, and the overall incidence of wound infection was significantly lower than the control group ( P 〈 0.05 ), the observation group 1-year survival and 2-year survival rates were higher. Conclusion No abdominal incision rectal eversion low colorectal cancer treatment, can significantly shorten the operation time, reduce bleeding, abdominal surgery to ensure that patients and beautiful, while alleviating anxiety and depression in patients with psychological, reduce complications and improve quality of life Conclusion Laparoscopic surgery improved survival rate.
出处
《中华普外科手术学杂志(电子版)》
2017年第3期233-236,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)