腹腔镜下经腹或经肛门内括约肌切除术治疗低位直肠癌的疗效对比

Comparison of the efficacy of laparoscopic transabdominal or transanal internal sphincterectomy in the treatment of low rectal cancer

目的探究腹腔镜下经腹或经肛门内括约肌切除术治疗低位直肠癌的临床疗效。方法64例低位直肠癌患者,随机分为观察组和对照组,各32例。对照组行腹腔镜下经腹内括约肌切除术治疗,观察组行腹腔镜下经肛门内括约肌切除术治疗。比较两组患者临床指标、Kirwan肛门功能及排便紧迫感、排便次数、大便失禁发生率。结果观察组术中出血量(70.34±10.31)ml、手术时间(193.13±20.42)min及肛门排气时间(2.63±0.49)h与对照组的(70.90±12.51)ml、(205.11±27.64)min、(2.96±1.22)h比较,差异无统计学意义(P>0.05)。观察组Kirwan肛门功能与对照组比较,差异无统计学意义(P>0.05)。观察组排便紧迫感、大便失禁发生率及排便次数与对照组比较,差异无统计学意义(P>0.05)。结论对低位直肠癌患者实施腹腔镜下经腹或经肛门内括约肌切除术治疗均安全有效,临床应根据患者具体病情,结合具体症状体征选择合适的术式治疗。

Objective To investigate the clinical efficacy of laparoscopic transabdominal or transanal internal sphincterectomy in the treatment of low rectal cancer.Methods A total of 64 patients with low rectal cancer were randomly divided into observation group and control group,with 32 cases in each group.The control group was treated with laparoscopic transabdominal internal sphincterectomy,and the observation group was treated with laparoscopic transanal internal sphincterectomy.The clinical indexes,anal function Kirwan grading,defecation urgency,average defecation times and incidence of fecal incontinence were compared between the two groups.Results The intraoperative blood loss(70.34±10.31)ml,operation time(193.13±20.42)min and anal exhaust time(2.63±0.49)h in the observation group were not statistically significant compared with(70.90±12.51)ml,(205.11±27.64)min and(2.96±1.22)h in the control group(P>0.05).There was no statistically significant difference in anal function Kirwan grading between the observation group and the control group(P>0.05).The defecation urgency,incidence of fecal incontinence and defecation times of the observation group were not statistically significant compared with those of the control group(P>0.05).Conclusion Laparoscopic transabdominal or transanal internal sphincterectomy is a safe and effective method for patients with low rectal cancer.The appropriate surgical treatment should be selected according to the patient’s specific condition and combined with specific symptoms and signs.