腹腔镜Dixon手术治疗低位直肠癌的临床效果分析

Clinical Study of Surgical Treatment of Low Rectal Cancer with Laparoscopic Dixon Operation

目的:探讨腹腔镜直肠前侧切除术(Dixon)治疗低位直肠癌的临床效果及并发症情况。方法:回顾性分析68例低位直肠癌患者资料,按照治疗方式均分为两组。观察组34例采用腹腔镜Dixon治疗,对照组34例行开腹手术治疗,观察并比较两组的手术耗时、术中出血量、术后胃肠功能恢复时间、住院时间情况;随访3年,统计并比较两组的病死率和复发/转移率。结果:观察组手术用时(135.8±21.4) min,短于对照组的(170.2±30.4) min(t=5.395);术中出血量观察组(51.6±30.2)mL,少于对照组的(108.3±21.4) mL(t=8.904);观察组胃肠功能恢复时间为(28.8±1.4) h,少于对照组的(34.7±3.0) h(t=10.392);观察组住院时间(8.5±1.3)d,少于对照组的(11.6±2.0) d(t=7.578,均P<0.05)。观察组术后排尿功能的Kirwan分级显著优于对照组(P<0.05)。随访3年,观察组的病死率32.35%、复发率8.82%,对照组分别为41.18%、11.76%,差异无统计学意义(均P>0.05)。结论:腹腔镜Dixon治疗低位直肠癌可保护肛门括约肌,机体创伤小、恢复快速,提高近远期的生存率、降低复发。

Objective To investigate the clinical effect of laparoscopic Dixon operation in patients with low rectal cancer.Methods The data of 68 patients with lower rectal cancer were retrospectively analyzed.The data were divided into 2 groups according to the treatment methods:the observation group of 34 cases with rectal anterior resection(Dixon)treatment and the control group of 34 patients underwent open surgery.The operation time,surgical bleeding amount,postoperative gastrointestinal function recovery time and hospitalization time of two groups were observed.The mortality rate and recurrence rate of two groups with 3 years follow-up were also counted.Results The operation time of patients in observation group was(135.8±21.4)min,which is shorter than that of control group(170.2±30.4)min(t=5.395).The amount of intraoperative bleeding in observation group was(51.6±30.2)mL,which is less than that in the control group(108.3±21.4)mL,(t=8.904).The gastrointestinal function recovery time of observation group was(28.8±1.4)h and the control group was(34.7±3)h(t=10.392).The hospitalization time of observation group was(8.5±1.3)d.It was shorter than that of control group(11.6±2)d(t=7.578).There was statistically significant difference between the two groups of data comparison(P<0.05).In 3 years follow-up,the mortality rate was 32.35%in the observation group and the recurrence rate was up to 8.82%in the observation group in the control group(χ2=0.569,χ2=0.159,P>0.05).There was no significant difference between the two groups.Conclusion Laparoscopic conservative surgery for low rectal cancer can protect the anal sphincter,give small trauma to the body,make rapid recovery,improve the survival rate and reduce the recurrence rate,so it is worth popularizing.