不同入路在中低位直肠癌患者经肛全直肠系膜切除术中的应用效果

Effect of Different Approaches in Transanal Total Mesorectal Excision for Patients with Middle and Low Colorectal Cancer

目的探讨不同入路在中低位直肠癌(CRC)患者经肛全直肠系膜切除术中的应用效果。方法选取2019年1月至2021年1月于信阳市第四人民医院接受手术治疗的76例中低位CRC患者为研究对象,按随机数字表法分为A组(38例,常规腹腔镜CRC手术入路)与B组(38例,经结肠系膜入路),对比两组手术临床指标、系膜切除完整程度,统计两组术后并发症发生情况。结果B组经腹游离时间[(102.43±24.18)min]、住院时间[(9.46±1.94)d]均短于A组[(125.79±29.85)min、(11.32±2.85)d],差异有统计学意义(P<0.05);B组系膜切除完整程度优于A组,差异有统计学意义(P<0.05);两组术后并发症比较,差异无统计学意义(P>0.05)。结论常规腹腔镜CRC手术入路与经结肠系膜入路在经肛全直肠系膜切除术中均安全可行,但与常规腹腔镜CRC手术入路相比,经结肠系膜入路更利于缩短经腹游离时间及住院时间,提高系膜切除完整程度。

Objective To explore the application of different approaches in transanal total mesorectal excision for patients with middle and low colorectal cancer(CRC).Methods A total of 76 patients with middle and low CRC patients who recieved surgical treatment in Xinyang Fourth People’s Hospital from January 2019 to January 2021 were selected as the research subjects,by a random number table,they were divided into group A(38 cases,conventional laparoscopic approach for CRC)and group B(38 cases,trans mesocolon approach),the clinical indexes,complete degree of mesangial excision of the two groups were compared,and the postoperative complications of the two groups were counted.Results The transabdominal free time[(102.43±24.18)min]and hospitalization time[(9.46±1.94)d]in group B were shorter than those in group A[(125.79±29.85)min,(11.32±2.85)d],and the difference was statistically significant(P<0.05).The complete degree of mesangial excision in group B was better than that in group A,and the difference was statistically significant(P<0.05).There was no statistical significant difference in postoperative complications between the two groups(P>0.05).Conclusion The conventional laparoscopic approach and trans mesorectal approach are safe and feasible in transanal total mesorectal excision for CRC,but compared with the conventional laparoscopic approach for CRC,the trans mesocolic approach is more conducive to shortening the transabdominal free time and hospitalization time,and improving the complete degree of mesorectal excision.