改良盆底缝合术在肛提肌外腹会阴联合切除术治疗低位直肠癌患者中的应用

Application of modified pelvic floor suture in patients with low rectal cancer treated with extralevator abdominoperineal excision

目的探讨改良盆底缝合重建技术在肛提肌外腹会阴联合切除术(ELAPE)治疗低位直肠癌患者中的应用效果。方法将64例低位直肠癌患者根据术中盆底缝合重建方式不同分为生物补片组(n=34)和改良缝合组(n=30)。比较两组患者围手术期相关指标、术后并发症发生情况及随访期内疾病复发、转移和患者生存情况。结果两组患者手术时间、术中出血量、并发症总发生率、局部复发率、远处转移率及1年总生存率比较,差异均无统计学意义(P>0.05);生物补片组患者盆底重建时间明显短于改良缝合组,术后住院时间明显长于改良缝合组,住院总费用明显多于改良缝合组,差异均有统计学意义(P<0.01)。结论 ELAPE术中,与采用生物补片进行盆底重建相比,改良缝合技术具有住院时间短、费用低等优点,其应用于低位直肠癌ELAPE术中安全、可行。

Objective To explore the application of modified pelvic floor suture in patients with low rectal cancer treated with extralevator abdominoperineal excision(ELAPE).Method The clinical data of 64 patients with low rectal cancer who underwent ELAPE were retrospectively analyzed.According to different intraoperative reconstruction methods of pelvic floor suture,these patients were divided into biological mesh group(n=34) and modified suture group(n=30).Perioperathve related indexes,postoperative complications,disease recurrence,metastasis and patients survival during follow-up period were compared between the two groups.Result There were no significant difference in total opera?tive time,intraoperative blood loss,overall incidence rate of complications,local recurrence rate,and distant metastasis rate as well as 1-year survival rate between the two groups(P>0.05);the time of pelvic floor reconstruction in biological mesh group was notably shorter,while postoperative hospitalization time was longer,and total hospitalization cost was higher than that in modified suture group(P<0.01).Conclusion In ELAPE,compared with biological patch for pelvic floor reconstruction,modified suture is accompanied with advantages such as short hospitalization time and low cost,demonstrating that it is safe and feasible in ELAPE for low rectal cancer.