经腹经肛腔镜全直肠系膜切除术在中低位直肠癌患者中的临床疗效分析

Analysis of Clinical Efficacy of Transabdominal Transanal Total Mesorectal Resection in Patients with Middle and Low Rectal Cancer

目的探讨分析在中低位直肠癌患者中应用经腹经肛腔镜全直肠系膜切除术的临床疗效。方法方便选取2017年2月—2020年5月在该院接受治疗的中低位直肠癌患者70例作为研究对象,随机分为两组:观察组35例患者,给予经腹经肛腔镜全直肠系膜切除术治疗;对照组35例患者,给予全直肠系膜切除术治疗。比较两组患者的手术时间、胃肠功能恢复时间、并发症发生情况、术中出血量、淋巴结清除数量及临床疗效。结果观察组的胃肠功能恢复时间(2.32±0.93)h、术中出血量(77.96±13.78)mL、淋巴结清除个数(12.46±2.43)个优于对照组,差异有统计学意义(t=8.986、12.242、2.439,P<0.05);观察组总有效率(97.14%)高于对照组(65.71%),并发症发生率(2.86%)低于对照组(22.86%),差异有统计学意义(χ^(2)=11.430、4.590,P<0.05)。结论和传统直肠癌手术治疗中低位直肠癌相比,经腹经肛腔镜全直肠系膜切除术对患者机体损伤更小,其可以加快患者术后康复速度,具有更好的疗效和安全性。

Objective To investigate and analyze the clinical efficacy of transabdominal transanal endoscopic mesorectal resection in patients with middle and low rectal cancer.Methods Seventy patients with middle and low rectal cancer who were treated in the hospital from February 2017 to May 2020 were conveniently selected as the research objects.They were randomly divided into two groups:35 patients in the observation group were given transabdominal transanal endoscopy mesenteric resection treatment;35 patients in the control group were treated with total mesenteric resection.The operation time,gastrointestinal function recovery time,complications,intraoperative blood loss,number of lymph nodes removed,and clinical efficacy were compared between the two groups.Results The gastrointestinal function recovery time of the observation group was(2.32±0.93)h,the intraoperative blood loss(77.96±13.78)mL,and the number of lymph nodes cleared(12.46±2.43)were better than those of the control group,and the difference was statistically significant(t=8.986,12.242,2.439,P<0.05);the total effective rate of the observation group(97.14%)was higher than that of the control group(65.71%),and the complication rate(2.86%)was lower than(22.86%)of the control group,and the difference was statistically significant(χ2=11.430,4.590,P<0.05).Conclusion Compared with traditional rectal cancer surgery for middle and low rectal cancer,trans-abdominal transanal total mesorectal resection has less damage to the patient's body,it can speed up the recovery of patients after surgery,and has better efficacy and safety.It is worth promoting and using.