经腹经肛双镜联合全直肠系膜切除术并改良Bacon术治疗低位直肠癌的临床效果

Clinical effect of laparoscopy and anoscopy assited transanal total mesorectal excision combined with modified Bacon’s operation on low rectal cancer

目的探讨经腹经肛双镜联合全直肠系膜切除术并改良Bacon术治疗低位直肠癌的临床效果。方法选择2019年8月至2021年1月在临沂市肿瘤医院接受治疗的65例低位直肠癌患者为研究对象,按照随机数表法分为观察组和对照组,观察组30例,对照组35例。观察组患者行经腹经肛双镜联合全直肠系膜切除术并改良Bacon术治疗,对照组患者采用腹腔镜下全直肠系膜切除术(TME)治疗。记录两组患者术中出血、耗时等相关情况;记录两组患者的早期并发症。结果观察组出血量明显少于对照组,且观察组手术用时更少,很好地保留患者的肛门,并且观察组患者首次下床活动和术后住院所用时间均少于对照组患者,观察组在短期内恢复地更快、更好(P<0.05)。观察组患者术后极少发生早期并发症,术后并发症如吻合口漏、排尿困难、切缘阳性和肿瘤播散等发生率均少于对照组(P<0.05)。结论经腹经肛双镜联合全直肠系膜切除术并改良Bacon术能够很好的运用在低位直肠癌患者的治疗中,不仅能够保证手术的质量,而且利于患者的恢复,术后并发症少。

Objective To observe the clinical effect of laparoscopy and anoscopy assited transanal total mesorectal excision combined with modified Bacon’s operation on low rectal cancer.Methods Sixyfive patients with low rectal cancer who were treated in Linyi Tumor Hospital from August 2019 to January2021 were selected as the research objects.They were divided into observation group and control group according to the random number table method.There were 30 cases in the observation group and 35 cases in the control group.The patients in the observation group were treated with laparoscopy and anoscopy assited transanal total mesorectal excision combined with modified Bacon’s operation,while the patients in the control group were treated with laparoscopic total mesenteric resection(TME).The intraoperative bleeding,time-consuming and other related conditions of the two groups were recorded,and the early complications of the two groups of patients were recorded.Results In the observation group,the blood loss was significantly less than that of the control group,and the operation time was less than that in the control group.The observation group preserved the patient’s anus well,and the time spent by the patients on getting out of bed for the first time and hospitalization after surgery in the observation group were less than those in the control group,and the patients in the observation group recovered faster and better in a short period of time(P<0.05).Patients in the observation group had very few early complications after surgery.The incidences of postoperative complications such as anastomotic leakage,dysuria,positive margins and tumor dissemination were lower than those in the control group(P<0.05).Conclusions laparoscopy and anoscopy assited transanal total mesorectal excision combined with modified Bacon’s operation can be well used in low rectal cancer,which can not only ensure the quality of operation in the early stage,but also is conducive to the recovery of patients,and with less complication.