经肛门内镜显微手术治疗直肠癌的近期疗效分析

Short-term effect analysis of transanal endoscopic microsurgery in the treatment of rectal cancer

目的探讨经肛门内镜显微手术治疗直肠癌的近期疗效。方法选取2014年12月至2016年12月接受手术治疗的82例直肠癌患者,根据术式不同分为TEM组(经肛门内镜显微手术治疗)和Miles组(经腹腔镜Miles术治疗),每组41例。应用SPSS 18.0软件对本次数据进行统计学分析,两组患者术中术后情况、应激反应程度采用(x±s)表示,组间比较独立t检验,以P<0.05表示差异具有统计学意义。结果 TEM组患者的手术时间、术中出血量、术后肛门排气时间、进食时间、下床活动时间和住院时间均显著低于Miles组(P<0.05);两组患者的淋巴结清扫数目差异无统计学意义(P>0.05)。术后,TEM组患者的肾上腺素(E)、去甲肾上腺素(NE)和皮质醇(Cor)含量均显著低于Miles组,差异具统计学意义(P<0.05)。结论经肛门内镜显微手术治疗直肠癌具有术后恢复更快,机体应激反应程度更低,是一种安全可行的手术方式。

Objective To investigate the short-term effect of transanal endoscopic microsurgery for rectal cancer. Methods 82 rectal cancer patients with surgical treatment in our hospital from December 2014 to December 2016 were divided into TEM group （transanal endoscopic microsurgery, TEM） and Miles group （laparoseopic Miles surgery）, with 41 cases in each group. Statistical analysis was performed by using SPSS 18.0 statistical software, the intraoperative and postoperative conditions, stress reaction degree between the two groups were expressed by （x ±s）, and examined by using independent t test, A P value 〈0.05 was considered as statistically significant difference. Results The operative time, amount of bleeding, anal exhaust time, feeding time, hospitalization time of the TEM group were significantly lower than those of the Miles group （ P 〈 0.05 ） , and there was no significant difference of lymphnodes number between the two groups （P 〉 0.05 ）. After operation, the epinephrine （ E）, Norasepin ephrine （NE） and Cortisol （Cor） content of the TEM group were significantly lower than those of the Miles group （ P 〈 0.05 ）. Conclusion Transanal endoscopic microsurgery for rectal cancer has a faster postoperative recovery and lower body stress response. It is a safe and feasible surgical method.