肛门内镜显微手术在腹腔镜直肠癌手术中应用效果研究

The application effect of laparoscopy combined with transanal endoscopicmic rosurgery in the treatment of rectal cancer

目的:探讨肛门内镜显微手术在腹腔镜直肠癌手术中的应用效果。方法:选取72例中高位直肠癌患者,随机分为实验组(腹腔镜联合肛门内镜显微手术)和对照组(常规腹腔镜手术)各36例。比较两组的手术时间,住院时间,术中输血例数,术后下床活动、排气时间及术后并发症,并对结果进行统计学分析。结果:与对照组相比,实验组患者手术时间短[(121.47±21.69)min与(140.14±22.83)min,t=-3.557,P=0.001]、住院时间短[(9±2.5)d与(12±2.9)d,t=-4.701,P=0.000]、下床时间早[(62.8±20.9)h与(85.6±24.7)min,t=-4.297,P=0.000]、肛门功能恢复早[(80.5±6.2)h与(84.6±8.5)h,t=-2.338,P=0.022]。所有患者均完成2年随访,均未出现肿瘤局部复发及转移。结论:腹腔镜联合肛门内镜显微手术行体外直肠癌根治性切除术可以有效缩短治疗时间,改善预后,是一种更为安全可靠的微创手术方式。

Objective:To discuss the application effect of laparoscopy combined with transanal endoscopic microsurgery in the treatment of rectal cancer.Methods:72 cases of high rectal cancer were enrolled and they were randomly divided into experimental group(laparoscopic combined endoscopic microsurgery anus)and control group(conventional laparoscopic surgery),each group was 36 cases.Operation time,hospitalization time,intraoperative blood transfusion cases,postoperative ambulation time,exhaust time and complications of two groups were compared,and the results were statistically analyzed.Results:Compared with control group,the operation time was shorter[(121.47±21.69)min vs(140.14±22.83)min,t=-3.557,P=0.001],the hospitalization time was shorter[(9±2.5)d vs(12±2.9)d,t=-4.701,P=0.000],the postoperative ambulation time was earlier[(62.8±20.9)h vs(85.6±24.7)h,t=-4.297,P=0.000]and the exhaust time was earlier[(80.5±6.2)h vs(84.6±8.5)h,t=-2.338,P=0.022].All the patients were completed 2 years of follow-up,and there were no local recurrence and metastasis tumor occurred.Conclusion:Laparoscopic operation combined endoscopic microsurgery in vitro anus colorectal cancer radical resection can effectively shorten the treatment time and improve the prognosis,is a more safe and reliable way of minimally invasive surgery.