腹腔镜下经肛拖出式直肠癌前切除术对低位直肠癌的疗效及对患者肛肠功能和生活质量的影响

Efficacy of Laparoscopic Transanal Drag-out Proctocolectomy for Low Rectal Cancer and Its Effect on Patients'Anorectal Function and Quality of Life

目的探讨腹腔镜下经肛拖出式直肠癌前切除手术对于低位直肠癌患者临床疗效、肛肠功能及生活质量的影响。方法选取153例行直肠癌手术治疗的患者,根据手术治疗方式的不同,分为研究组及对照组两组,其中研究组采用腹腔镜下经肛拖出式直肠癌前切除术治疗,对照组采用腹腔镜辅助直肠癌前切除术治疗,比较2组患者的临床疗效等差异。结果研究组患者的手术时间、住院时间、术后首次排气时间及术后并发症发生率均显著优于对照组(P<0.05),而在术中淋巴结清扫数量及出血量方面比较无差异(P>0.05);术前两组患者的血清胃泌素及胃动素水平比较均无差异(P>0.05),而术后3天研究组患者的血清胃泌素及胃动素水平均较对照组改善明显(P<0.05);术前两组患者的肛门功能相关指标比较均无差异(P>0.05),而术后3天研究组患者的肛门功能相关指标均较对照组改善明显(P<0.05);术前两组患者的生活质量相关指标比较均无差异(P>0.05),而术后半年研究组患者的生活质量相关指标均较对照组改善明显(P<0.05)。结论腹腔镜下经肛拖出式直肠癌前切除术治疗低位直肠癌的疗效更为显著,同时对机体的肛肠功能影响较小,并能改善患者的生活质量,值得临床推广应用。

Objective To analyze the efficacy of laparoscopic transanal drag-out proctocolectomy for low rectal cancer and its effect on patients'anorectal function and quality of life.Methods 153 patients with rectal cancer were selected and divided into the study group and the control group according to different surgical treatment methods.The study group was treated by laparoscopic transanal drag-out proctocolectomy and the control group was treated by laparoscopic-assisted proctocolectomy,comparing the clinical efficacy and other differences between the 2 groups.Results The patients in the study group had significantly shorter operative time,hospital stay,first postoperative venting time and lower postoperative complication rate than the control group(P<0.05),while there was no difference in the number of intraoperative lymph node dissection and bleeding volume(P>0.05);There was no difference in the serum gastrin and motilin levels between the 2 groups before surgery(P>0.05),while the serum gastrin and motilin levels in the study group improved significantly compared with the control group 3 days after surgery(P<0.05).There was no difference in the indexes related to anal function between the 2 groups before surgery(P>0.05),while the indexes related to anal function in the study group improved significantly compared with the control group 3 days after surgery(P<0.05);There was no difference in the indexes related to quality of life between the 2 groups before surgery(P>0.05),while the indexes related to quality of life in the study group improved significantly compared with the control group 6 months after surgery(P<0.05).Conclusion The efficacy of laparoscopic transanal drag-out proctocolectomy for the treatment of low rectal cancer is more significant,and at the same time,it has less impact on the body's anorectal function and can improve the quality of life of patients,so it is worthy of clinical promotion.