经肛拖出式全腹腔镜直肠前切除术在中低位直肠癌中的应用体会

The safety and efficacy of transanal pull through laparoscopic rectal resection in low rectal carcinoma

目的观察经肛拖出式全腹腔镜直肠前切除术在中低位直肠癌中的手术相关指标及并发症发生情况。方法选取2014年3月至2016年4月本院收治的100例中低位直肠癌患者为研究对象,随机分为观察组和对照组,每组各50例。观察组采用经肛拖出式全腹腔镜前切除术,对照组采取腹腔镜辅助直肠前切除术。比较两组手术时间、手术费用、术中出血量、肛门排气时间、清扫淋巴结个数以及并发症发生情况。结果观察组住院时间、手术费用、术中出血量、肛门排气时间均显著少于对照组,观察组清扫淋巴结个数显著多于对照组,差异均有统计学意义(均P<0.05)。观察组与对照组并发症总发生率分别为4.00%、10.00%,差异无统计学意义(P>0.05)。结论与腹腔镜辅助直肠前切除术相比,经拖出式全腹腔镜下直肠前切除术治疗中低位直肠癌手术相关指标总体情况更优,且未增加术后并发症发生率。

Objective To study the safety and efficacy of transanal pull through laparoscopic rectal resection in low rectal carcinoma. Methods 100 patients with middle and lower rectal cancer patients who received treatment in our hospital from March 2014 to April 2016 were selected. Using a random number table method, patients were divided into treatment group （50 cases） and control group （50 cases）. Patients in the control group received laparoscopic assisted rectal anterior resection, and patients in the treatment group received transanal pull type total laparoscopic anterior resection. We compared between the two groups operation time, operation cost, intraoperative bleeding volume, anal exhaust time, lymph node number and the incidence of complications. Results The hospitalization time, operation cost in the treatment group was lower than those in the control group （P 〈 0.05）. Intraoperative bleeding, anal exhaust time in the treatment group was significantly lower than those in the control group and number of lymph node dissection was greater than that in the control group （P 〈 0.05）. The incidence of complication was significantly different between the two groups （P 〈 0.05）. Conclusion Transanal pull through laparoscopic rectal resection in the treatment of low rectal cancer has advantages of low cost operation time and operation through, and resulted in more lymph node dissection, fewer complications.