腹腔镜直肠癌经肛门全直肠系膜切除术与腹腔镜直肠癌根治术治疗直肠癌的临床效果

Clinical effect of laparoscopic rectal cancer transanal total mesorectal excision and laparoscopic radical surgery in the treatment of rectal cancer

目的探讨腹腔镜直肠癌经肛门全直肠系膜切除术(TaTME)与腹腔镜直肠癌根治术治疗直肠癌的临床效果。方法选取2017年2月~2019年5月我院收治的90例直肠癌患者作为研究对象,按照随机数字表法将其分为两组,每组各45例。A组患者行腹腔镜直肠癌TaTME术,B组患者行常规腹腔镜直肠癌根治术。比较两组患者的手术相关指标、术后肛门功能、并发症总发生率。结果A组患者的手术用时、淋巴结清扫数、手术标本移除长度与B组比较,差异无统计学意义(P>0.05);A组患者的术后排气时间、首次下床活动时间和住院时间均短于B组,术后肛门功能恢复优良率高于B组,术中失血量少于B组,术后并发症总发生率低于B组,差异有统计学意义(P<0.05)。结论与腹腔镜直肠癌根治术相比,使用腹腔镜直肠癌TaTME治疗直肠癌的安全性更高,能减少患者的术中失血量,缩短术后恢复时间,促进肛门功能恢复。

Objective To investigate the clinical effect of laparoscopic rectal cancer transanal total mesorectal excision(TaTME)and laparoscopic radical surgery in the treatment of rectal cancer.Methods A total of 90 patients with rectal cancer who were admitted and treated in our hospital from February 2017 to May 2019 were selected as subjects.According to the random number table method,they were divided into two groups,with 45 cases in each group.Group A was given laparoscopic rectal cancer TaTME method.Group B was given conventional laparoscopic radical resection of rectal cancer.Surgery-related indicators,postoperative anal function,and overall incidence of complications were compared between the two groups.Results There were no statistically significant differences in the surgery time,number of lymph node dissections,and length of surgical specimen removal in group A compared with those in group B(P>0.05).The postoperative exhaust time,the first time for off-bed activity,and the length of hospital stay in group A were shorter than those in group B,the postoperative recovery rate of anal function was higher than that in group B,the blood loss during operation was less than that in group B,and the overall incidence of postoperative complications was lower than that in group B,the differences were statistically significant(P<0.05).Conclusion Compared with laparoscopic radical surgery of rectal cancer,the application of laparoscopic rectal cancer TaTME in the treatment of rectal cancer is safer,which can reduce blood loss during surgery,shorten postoperative recovery time,and promote anal function recovery.