腹腔镜超低位直肠癌经括约肌间切除术治疗低位直肠癌的疗效观察

Observation on efficacy of laparoscopic intersphincteric resection of ultra-low rectal cancer in treatment of low rectal cancer

目的探讨腹腔镜超低位直肠癌经括约肌间切除术(LISR)治疗低位直肠癌的疗效。方法 150例低位直肠癌患者按照随机数字表法随机分为对照组与观察组,每组75例。对照组采用开腹超低位直肠癌经括约肌间切除术(OISR)治疗,观察组采用LISR术治疗。比较两组患者手术时间、术中出血量、术后并发症发生率、术后1个月死亡率、术后1个月肛管静息压及肛管收缩压。结果观察组手术时间短于对照组,术中出血量少于对照组,术后并发症发生率低于对照组,术后1个月肛管静息压及肛管收缩压均高于对照组(均P <0. 05),但两组术后1个月死亡率比较,差异无统计学意义(P> 0. 05)。结论 LISR术治疗直肠癌疗效确切,可减少患者手术时间及术中出血量,降低术后并发症发生率,并最大程度的保留肛门及其功能,提高患者生活质量。

Objective To explore the efficacy of laparoscopic intersphincteric resection(LISR) of ultra-low rectal cancer in the treatment of low rectal cancer. Methods A total of 150 patients with low rectal cancer were divided into control group and observation group using the random number table,with 75 cases in each group. The control group was treated with open intersphincteric resection(OISR) of ultra-low rectal cancer,while the observation group was treated with LISR of ultra-low rectal cancer. The duration of operation,intraoperative blood loss,incident rate of postoperative complications,mortality at 1 month after operation,anal canal resting pressure and systolic pressure at 1 month after operation were compared between the two groups. Results Compared to the control group,the duration of operation was shorter, the intraoperative blood loss was less,the incident rate of postoperative complications was lower,and the anal canal resting pressure and systolic pressure at 1 month after operation were higher in the observation group(all P < 0. 05). But there was no statistical difference in the mortality at 1 month after operation between the two groups(P > 0. 05). Conclusion LISR obtains a definite efficacy for treating rectal cancer,can decrease the duration of operation and intraoperative blood loss,reduce the incident rate of postoperative complications,preserves the anus and its function to the greatest extent,and improves the life quality of patients.