侧方淋巴结清扫术在低位直肠癌的临床应用

Clinical application of lateral lymph node dissection in low rectal cancer

探讨低位直肠癌手术中保留盆腔自主神经并行侧方淋巴结清扫的临床效果与安全性.以2019年3月~2020年12月到淮北市人民医院进行全直肠系膜切除(TME)手术的低位直肠癌患者60例为研究对象,根据术中是否行侧方淋巴结清扫(LLND)术分为观察组和对照组各30例,对照组患者行TME手术,观察组患者行TME+LLND手术,比较2组患者手术相关指标、炎症因子、排尿功能、性功能、1年复发率以及1年生存率等指标.观察组患者手术时间、术中出血量均高于对照组,差异有统计学意义(P<0.05);观察组与对照组患者术后排尿功能、性功能、1年复发率、1年生存率、并发症发生率均无统计学差异(P>0.05).直肠癌患者TME术后进行LLND,手术时间和术中出血量虽有增加,但手术仍安全可靠.

The paper evaluated the clinical effect and safety of of preserving pelvic autonomic nerves and performing lateral lymph node dissection(LLND)in low rectal cancer surgery.60 patients with low rectal cancer in Huaibei People′s Hospital who received total mesorectal resection(TME)from March 2019 to December 2020 were analyzed retrospectively.The patients were divided into observation group(30 cases)and control group(30 cases)according to whether or not LLND was performed during the operation.Patients in the control group underwent TME,while patients in the observation group underwent TME+LLND.Surgery-related indicators,inflammatory factors,urinary function,sexual function,1-year recurrence rate,and 1 Indicators such as annual survival rate were compared between the two groups.The operation time and intraoperative blood loss of the observation group were higher than those of the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in postoperative urination function,sexual function,1-year recurrence rate,1-year survival rate,and complication rate(all P>0.05).Although TME+LLND increased the operation time and intraoperative blood loss,the operation is still safe and reliable.