中低位直肠癌行保肛手术术后吻合口效果的临床分析

Clinical analysis of anastomotic effect after anus preserving surgery for middle and low rectal cancer

目的探讨临床中低位直肠癌患者应用全直肠系膜切除联合国产双吻合器保肛术方案治疗效果及对吻合口瘘的防范作用。方法 40例中低位直肠癌患者,随机分为对照组(18例)和观察组(22例)。对照组采用传统经腹会阴联合直肠癌切除术治疗,观察组采用全直肠系膜切除联合国产双吻合器保肛术治疗。比较两组患者的手术时间、术中出血量、术后吻合口瘘发生情况及术后1年复发情况。结果观察组患者手术时间明显短于对照组,术中出血量明显少于对照组,差异具有统计学意义(P<0.05)。观察组术后吻合口瘘发生率4.5%和术后1年复发率4.5%均显著低于对照组的27.8%和33.3%,差异具有统计学意义(P<0.05)。结论中低位直肠癌患者应用全直肠系膜切除联合国产双吻合器保肛术治疗,可显著改善手术质量,防范吻合口瘘,降低复发率。

0bjective To investigate the clinical effect of total mesorectal excision combined with home-made double stapler anus preserving surgery for middle and low rectal cancer and its prevention effect of anastomotic leakage in the clinical. Methods A total of 40 patients with middle and low rectal cancer were randomly divided into control group for 18 cases and observation group for 22 cases. The control group was treated with traditional transabdominal perineal resection combined with rectal cancer resection, the observation group was treated with total mesorectal excision combined with home-made double stapler anus preserving surgery. The operative time, intraoperative blood loss, postoperative anastomotic leakage and recurrence after 1 year were compared between the two groups. Results The operative time of the observation group was significantly shorter than that of the control group, and the intraoperative blood loss of the observation group was significantly less than that of the control group, the differences were statistically significant （P〈0.05）. The incidence of anastomotic leakage and the recurrence rate in the observation group were 4.5% and 4.5% respectively, which were significantly lower than 27.8% and 3313% in the control group, the differences were statistically significant （P〈0.05）. Conclusion The application of total mesorectal excision combined with home-made double stapler anus preserving surgery for middle and low rectal cancer can significantly improve the quality of surgery, prevent anastomotic fistula and reduce the recurrence rate.