腹腔镜全直肠系膜切除术治疗老年中低位直肠癌的近期疗效及安全性

Clinical Efficacy and Safety of Laparoscopic Total Mesorectal Excision in the Treatment of Middle and Low Rectal Cancer in the Elderly

目的探讨研究腹腔镜全直肠系膜切除术治疗老年中低位直肠癌的近期疗效及安全性。方法随机抽选2016年1月—2017年1月期间该院收治的76例老年中低位直肠癌患者,将其按照不同的手术治疗方法平均分成两组,观察组和对照组,每组38例。其中,对照组患者给予开腹全直肠系膜切除术进行治疗,观察组患者给予腹腔镜全直肠系膜切除术,比较两组患者的临床指标、术后指标以及并发症发生概率。结果观察组患者的手术时间、术中出血量以及住院时间分别为(115.25±18.25)min、(83.26±18.24)m L、(6.24±1.35)d均优于对照组的对应值;观察组患者的术后镇痛时间、留置尿管时间、肛门排气时间、恢复进食时间分别为(1.85±0.56)d、(3.84±0.15)d、(48.21±13.68)h、(2.85±0.75)d均优于对照组的对应值;观察组患者的并发症发生率为13.15%,明显低于对照组的42.11%(P<0.05)。结论对老年中低位直肠癌采用腹腔镜全直肠系膜切除术进行治疗,治疗效果显著,不仅有利于减少患者的手术时间和降低其术中出血量,还有助于改善患者的术后各项临床指标,并且其并发症少,有效加快患者身体健康的恢复进度,安全性更高,具有较好的临床价值,值得推广。

Objective This paper tries to investigate the short-term efficacy and safety of laparoscopic total mesorectal excision for the treatment of middle and low rectal cancer in the elderly. Methods A total of 76 elderly patients with middle and low rectal cancer from Januany 2016 to Januaty were randomly divided into two groups： the observation group and the control group according to different surgical methods, with 38 cases in each group. Among them, the control group of patients underwent open total mesorectal excision treatment, the observation group of patients was given laparoscopic total mesorectal excision, and then the clinical index, postoperative index and complications of the two groups of patients were compared. Results The operation time, intraoperative blood loss and hospi-talization time of the observation group were（115.25 ±18.25）min,（83.26±18.24）m L,（6.24±1.35）d, better than those of the control group. The postoperative analgesia time, indwelling catheter time, anal exhaust time, recovery time in the observation group were（1.85±0.56）d,（3.84±0.15）d,（48.21±13.68）h,（2.85±0.75）d, better than the control group; the complication rate in the observation group was 13.15%, significantly lower than that in the control group of 42.11%（P〈0.05）. Conclusion Laparoscopic total mesorectal excision for the treatment of middle and low rectal cancer in the elderly is not only beneficial to reduce the operation time of the patients and reduce the amount of blood loss in the patients, but also help to improve the postoperative clinical indicators of the patients, with few-er complications, which can effectively accelerate the recovery of the health of patients, with higher safety and better clinical value,therefore it is worth promotion.