腹腔镜下抵钉座手工捆扎固定技术在完全腹腔镜下直肠癌前切除术中的效果分析

Analysis on effect of laparoscopic manual binding and fixation with nail holder in complete laparoscopic anterior resection of rectal cancer

目的分析腹腔镜下抵钉座手工捆扎固定技术在完全腹腔镜下直肠癌前切除术中的应用效果。方法选择2019年6月至2020年12月收治的150例直肠癌患者,采用随机数字表均分为两组,观察组75例,采用腹腔镜抵钉座手工捆扎固定术治疗,对照组75例,采用腹腔镜抵钉座荷包缝合固定术治疗。结果观察组术中出血量明显更少,手术时间、术后排气时间和住院时间明显短于对照组,差异有统计学意义(P<0.001)。观察组C反应蛋白(CRP)、丙二醛(MDA)水平低于对照组,超氧化物歧化酶(SOD)水平高于对照组,差异有统计学意义(P<0.001)。术后3天和7天观察组降钙素原(PCT)、白介素6(IL-6)水平较对照组显著降低(P<0.01)。两组术后切口感染、吻合口漏、吻合口狭窄及出血等并发症发生率比较,观察组并发症发生率为2.66%,低于对照组的12.00%(P<0.05)。结论在完全腹腔镜下直肠癌前切除术中应用手工捆扎法进行抵钉座固定技术,安全性更高,术后恢复更快,值得推广。

Objective To analyze the effect of laparoscopic manual binding and fixation with nail holder in complete laparoscopic anterior resection of rectal cancer. Methods 150 patients with rectal cancer treated from June 2019 to December 2020 were divided into two groups according to random number table. 75 patients in observation group were treated with laparoscopic manual binding and fixation with nail holder, and 75 patients in control group were treated with laparoscopic nail holder purse string suture and fixation. Results The amount of intraoperative bleeding in the observation group was significantly less, and operation time, postoperative exhaust time and hospital stay were significantly shorter than those in the control group, and difference was statistically significant(P<0.001). The levels of C-reactive protein(CRP) and malondialdehyde(MDA) in the observation group were lower than those in the control group, and the level of superoxide dismutase(SOD) was higher than that in the control group, and difference was statistically significant(P<0.001). The levels of procalcitonin(PCT) and interleukin-6(IL-6) in the observation group were significantly lower than those in the control group at 3 and 7 days after operation(P<0.01). The incidence of postoperative complications such as incision infection, anastomotic leakage, anastomotic stenosis and bleeding in the observation group was 2.66%, lower than that in the control group(12.00%)(P<0.05). Conclusion In total laparoscopic anterior resection of rectal cancer, laparoscopic manual binding and fixation with nail holder has higher safety and faster postoperative recovery, which is worthy of popularization.