不同腹腔镜经腹会阴联合切除术治疗低位直肠癌的近中期随访比较

Comparison of different laparoscopic combined abdominal perineal resection in the treatment of low rectal cancer

目的分析不同腹腔镜经腹会阴联合切除术治疗低位直肠癌的近中期效果。方法选取2016年1月至2018年5月期间80例低位直肠癌患者病例资料,根据术中盆底腹膜关闭与否,将采用未实施盆底腹膜关闭的腹腔镜经腹会阴联合切除术治疗的40例患者纳入未关闭组,采用腹腔镜经腹会阴联合切除术联合盆底腹膜关闭治疗的40例患者纳入关闭组。采用SPSS 23.0软件进行处理,手术相关指标、生活质量(GQOLI-74)评分以(x±s)表示,独立t检验;并发症发生率用百分比表示,用χ^(2)检验。P<0.05为差异有统计学意义。结果所有患者均顺利完成手术,关闭组手术时间、术中出血量多于未关闭组,肠道功能恢复时间、引流管拔除时间短于未关闭组,并发症发生率低于未关闭组,GQOLI-74评分高于未关闭组(P<0.05)。结论腹腔镜经腹会阴联合切除术中盆腔腹膜关闭能够降低低位宜肠癌患者术后并发症风险,促进术后恢复,提高术后生活质量。

Objective To analyze the effects of different laparoscopic transabdominal perineal resection in the treatment of low rectal cancer.Methods The data of 80 patients with low rectal cancer from January 2016 to may 2018 were selected.According to whether the pelvic floor peritoneum was closed or not,40 patients treated with laparoscopic combined perineal resection without pelvic floor peritoneum closure were included in the open group,Forty patients treated with laparoscopic transabdominal perineal resection combined with pelvic floor peritoneal closure were included in the closure group.SPSS23.0 software was used for processing.Surgery-related indicators and quality of life(GQOLI-74)scores were expressed as(x±s)and independent t-test;complication rate and tumor recurrence rate were expressed as percentages,andχ^(2)test was used;survival P<0.05 was considered statistically significant.Results All patients completed the operation smoothly.The operation time and blood loss in the closed group were more than those in the open group,and the recovery time of intestinal function and extubation time were shorter than those in the open group,the incidence of complications was lower than that in the open group,and the GQOLI-74 score was higher than that in the open group(P<0.05)Conclusions Pelvic peritoneal closure during laparoscopic combined abdominal perineal resection can reduce the risk of postoperative complications,promote postoperative recovery and improve postoperative quality of life in patients with low rectal cancer.