腹腔镜辅助经肛全直肠系膜切除术治疗直肠癌临床疗效评价

Clinical evaluation of laparoscopic-assisted transanal total mesorectal excision for rectal cancer

目的探讨腹腔镜辅助经肛全直肠系膜切除术(腹腔镜辅助taTME)用于治疗直肠癌的临床疗效。方法选取2019年5月—2021年5月行腹腔镜全直肠系膜切除术(TME)治疗的34例直肠癌患者作为对照组,同期选取进行腹腔镜辅助下经肛全直肠系膜切除术(taTME)手术治疗的46例直肠癌患者作为观察组,对其临床资料进行回顾性分析。结果观察组手术时间、出血量、住院时间、术后并发症发生率显著少于对照组(P<0.05),生活质量改善亦显著好于对照组(P<0.05);但两组淋巴结清扫总数、保肛成功率、切缘阳性率、术后首次进食时间及肛门首次排气时间无差异(P>0.05)。结论腹腔镜辅助下taTME手术治疗直肠癌在保证手术效果的同时可显著缩短手术时间、降低重要神经血管损伤及术后并发症,值得临床推广。

Objective To investigate the clinical efficacy of laparoscopic-assisted transanal total mesorectal excision(laparoscopic-assisted taTME)on rectal cancer.Methods From May 2019 to May 2021,34 cases of rectal cancer who underwent laparoscopic total mesorectal excision(TME)were selected as control group,and 46 cases of rectal cancer with taTME were selected as observation group.The clinical data were retrospectively analyzed.Results The operation time,blood loss,length of hospital stay,and incidence rate of postoperative complications in the observation group were significantly less than those in the control group(P<0.05),and the quality of life in the observation group was better than that in the control group(P<0.05).There were no significant differences in the total number of lymph nodes dissected,success rate of anal preservation,rate of positive margin resection,time of first postoperative eating,and time of first anal exhaust between the two groups(P>0.05).Conclusion Laparoscopic-assisted taTME surgery in the treatment of rectal cancer can significantly shorten operation time,reduce important neurovascular injury and postoperative complications,while ensure surgical effect,which is worthy of clinical promotion.