两种二次手术方法治疗腹腔镜结直肠癌术后吻合口漏的临床比较

Clinical comparison of two methods of secondary operation in the treatment of postoperative anastomotic leakage after laparoscopic colorectal cancer

目的比较两种二次手术方法治疗腹腔镜结直肠癌术后吻合口漏的临床效果。方法回顾性分析2018年12月至2020年6月66例腹腔镜结直肠癌术后吻合口漏患者病例资料,根据术式不同分为腹腔镜组(34例)和开腹组(32例)。采用SPSS 23.0统计分析软件,手术相关指标、生活自理能力、泌尿功能评分等计量资料以(x±s)表示,独立样本t检验;并发症发生率采用χ^(2)检验。P<0.05为差异有统计学意义。结果腹腔镜组术中出血量、术后排气时间、住院时间均少于开腹组(P<0.05)。两组手术时间、术后再次外科干预发生率、造口已还纳发生率、并发症总发生率相比,差异无统计学意义(P>0.05)。腹腔镜组术后巴氏指数(BI)量表评分、膀胱功能评定量表评分均比开腹组高,差异有统计学意义(P<0.05)。结论相比开腹手术,采用腹腔镜手术治疗腹腔镜结直肠癌术后吻合口漏可减少术中对机体造成的创伤,改善患者术后生活自理能力及泌尿功能,且不会增加并发症风险。

Objective To compare the clinical effect of two kinds of secondary operation in the treatment of anastomotic leakage after laparoscopic colorectal cancer operation.Methods The clinical data of 66 patients with anastomotic leakage after laparoscopic colorectal cancer surgery from December 2018 to June 2020 were analyzed retrospectively.According to different surgical procedures,34 cases were divided into the laparoscopic group,while 32 cases were divided into the laparotomy group.Statistical analysis were performed by using SPSS 23.0 software.The measurement data of operation related indexes,self-care ability and urinary function were expressed as,and were examined by using independent sample t test.The incidence rate of complication was analyzed by usingχ^(2) test.A P value of<0.05 was considered as statistically significant difference.Results Compared with the laparotomy group,decreased intraoperative blood loss,quicker postoperative exhausting time,and shortened length of hospitalization were observed in the laparoscopic group(P<0.05).There were no significant difference between the two groups in terms of the operation time,the incidence of re-surgical intervention after the operation and closure of stoma\,and the total incidence of complications(P>0.05).The scores of the BI scale and the bladder function assessment scale were higher in the laparoscopic group than those in the laparotomy group respectively(P<0.05).Conclusion Compared with laparotomy,using laparoscopic surgery to deal with the anastomotic leakage after laparoscopic colorectal cancer could reduce the trauma to the body during the operation,with improved selfcare ability and urinary function after surgery,without increasing the risk of complications.