腹腔镜辅助直肠外翻技术对行低位直肠癌保肛手术患者的疗效及预后分析

Efficacy and prognostic analysis of laparoscopic assisted rectal valgus technique for patients with low rectal cancer anus surgery

目的探讨腹腔镜辅助直肠外翻技术在低位直肠癌保肛手术中的疗效及预后。方法回顾性分析2014年8月至2016年8月收治的81例直肠癌患者的病例资料,按照治疗方法分为对照组和观察组,其中对照组采用开腹低位直肠癌前切除术(40例),观察组行腹腔镜辅助直肠外翻技术治疗低位直肠癌保肛术(41例);观察两组患者手术时间、术中出血量、住院时间、复发率、术后近期并发症的发生情况、术后肛门排便功能(随访6个月)。结果两组患者均顺利完成手术,观察组手术时间[(173.43±7.56)d]、术中出血量[(113.73±6.58)ml]、住院时间[(9.57±0.98)d]均明显低于对照组(P<0.05);观察组出现1例吻口漏;对照组出现1例吻口漏,1例吻合口出血,两组患者均无死亡,两组近期吻合口并发症发生率差异无统计学意义(P>0.05);随访半年,观察无瘤局部复发情况,对照组2例(复发率5%);两组肛门均保存了控制排便功能,观察组在术后2周后每天排便次数多于对照组,差异具有统计学意义(t=11.821,P=0.000);术后6个月,两组患者每天排便次数差异无统计学意义(P>0.05)。结论腹腔镜辅助直肠外翻技术治疗低位直肠癌保肛手术的疗效良好,具有重要的临床应用价值。

Objective To explore the efficacy and prognosis of laparoscopy assisted rectal eversion operation. Methods This study had retrospectively analyzed the clinical data of 81 patients with rectal cancer during August 2014 to August 2016, they were randomly divided into two groups according to number table method, patients in control group received laparoscopy assisted anterior rectal resection （40 cases） and patients in observation group received laparoscopy assisted rectal eversion operation （41 cases）. The operating time, amouunt of surgical blood loss, hospital stay, recurrence rate, postoperative complications and anus bowel function after surgery during the follow-up period （half year） had been compared between these 2 groups. Results Patients in these two groups were successfully operated. The operating time [（173.43±7.56） days], blood loss [（113.73±6.58） ml], hospital stay [ （9.57±0.98） days] were significantly shorter than those of control group （ P 〈0.05）. One case in observation group appeared kiss mouth leakage, and 1 case in control group had anastomotic bleeding, there was no death in these 2 groups, and the difference in recent anastomotic complications between these two goup had no statistical significance （ P 〉0.05）. Follow-up for half a year, patients in observation group had no tumor recurrence, and 2 cases in control group had recurrence （5%）. Patients in these two groups had preserved the function of anus control defecation, the postoperative bowel movements per day in observation group was better than that of control group, and the difference had statistical significance （ t =11.821, P =11.821）. After half a year, the difference in the daily stool frequency between these 2 groups had no statistical significance （ P 〉0.05）. Conclusion Laparoscopy assisted rectal operation is an effective procedure for rectal cancer. It has important clinical value.