吻合器经肛门直肠黏膜选择性切除钉合术治疗低位直肠良性肿瘤临床疗效研究

Curative effect of selective resection and nailing of the rectal mucosa with stapler through the anus in patients with low rectal benign tumors

目的:探讨吻合器经肛门直肠黏膜选择性切除钉合术对低位直肠良性肿瘤患者的治疗效果。方法:选取100例低位直肠良性肿瘤患者作为研究对象,以随机数字表法将所选患者分为对照组(n=50)及研究组(n=50)。对照组采用传统经肛门肿物切除术治疗,研究组采用吻合器经肛门直肠黏膜选择性切除钉合术治疗,两组术后均随访1年。比较两组围术期手术指标,术前、术后3、7 d的疼痛程度,随访期间的复发率及并发症发生率。结果:研究组平均术中出血量低于对照组,且平均手术及住院时间均短于对照组(均P<0.01)。与术前比较,术后3、7 d,两组视觉模拟评分法(VAS)评分均逐渐降低,研究组均低于对照组(均P<0.05)。研究组随访期间的复发率、并发症发生率分别为2.00%、12.00%,均低于对照组的20.00%、34.00%(均P<0.05)。结论:与传统经肛门肿物切除术比较,吻合器经肛门直肠黏膜选择性切除钉合术可明显改善低位直肠良性肿瘤患者围术期指标,并可减轻患者术后疼痛程度,进而有利于预防病情复发,且安全性更高。

Objective:To investigate the curative effect of selective resection and nailing of the rectal mucosa with stapler through the anus in patients with low rectal benign tumors.Methods:100 patients with low rectal benign tumors were selected and divided into control group(50 cases)and study group(50 cases)by random table method.The control group was treated with traditional transanal mass resection,and the study group was treated with selective resection and nailing of the rectal mucosa with stapler through the anus.Both groups were followed up for one year.The perioperative indexes,the pain degree before and 3,7 days after operation,the recurrence rate and the incidence of complications during followed up were compared between the two groups.Results:The average intraoperative blood loss of the study group was lower than that of the control group,and the time of average operation and hospitalization were shorter than those of the control group(all P<0.05).The VAS scores of the two groups gradually decreased at 3,7 days after operation,and the study group was lower than the control group(all P<0.05).The rates of recurrence and complications during followed up in the study group were 2.00%and 12.00%,which were lower than those in the control group(20.00%and 34.00%)(all P<0.05).Conclusion:Compared with traditional transanal mass resection,selective resection and nailing of the rectal mucosa with stapler through the anus can significantly improve the perioperative indexes of patients with low rectal benign tumors,and reduce the degree of postoperative pain,which was beneficial to prevent the condition recurs and has higher safety.