腹部无辅助切口经肛门取标本的腹腔镜低位直肠癌切除术在低位直肠癌患者中的应用效果

Application effect of laparoscopic low rectal cancer resection without assisted abdominal incision and transanal specimen extraction in patients with low rectal cancer

目的探讨腹部无辅助切口经肛门取标本的腹腔镜低位直肠癌切除术在低位直肠癌患者中的应用效果。方法根据手术方式的不同将80例低位直肠癌患者分为对照组(n=45)和观察组(n=35),对照组患者采用常规腹腔镜低位直肠癌根治术,观察组患者采用腹部无辅助切口经肛门取标本的腹腔镜低位直肠癌切除术。比较两组患者的手术相关指标、疼痛程度[视觉模拟评分法(VAS)评分]、C反应蛋白(CRP)水平和术后并发症发生情况。结果观察组患者的手术时间明显长于对照组,术后住院时间明显短于对照组,差异均有统计学意义(P﹤0.01)。术后3、7天,两组患者的VAS评分均高于本组术前1天,观察组患者的VAS评分均低于对照组,差异均有统计学意义(P﹤0.05)。术后3、7天,两组患者的CRP水平均高于本组术前1天,观察组患者的CRP水平均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的并发症总发生率为5.71%(2/35),与对照组患者的11.11%(5/45)比较,差异无统计学意义(P﹥0.05)。结论与腹腔镜下低位直肠癌切除术相比,腹部无辅助切口经肛门取标本的腹腔镜低位直肠癌切除术的手术时间更长,术后患者住院时间更短,疼痛更轻微,并发症发生率更低。

Objective To investigate the effect of laparoscopic low rectal cancer resection without assisted abdominal incision and transanal specimen extraction in patients with low rectal cancer.Method A total of 80 patients with low rectal cancer were divided into control group(n=45)and observation group(n=35)according to different surgical methods.Patients in the control group received conventional laparoscopic radical resection of low rectal cancer,and patients in the observation group underwent laparoscopic low rectal cancer resection without assisted abdominal incision and transanal specimen extraction.The operation-related indicators,pain degree[visual analogue scale(VAS)score],C-reactive protein(CRP)level and postoperative complications were compared between the two groups.Result The operation time of the observation group was significantly longer than that of the control group,and the postoperative hospital stay was significantly shorter than that of the control group,and the differences were statistically significant(P<0.01).On the third and seventh day after the operation,the VAS scores of the two groups were higher than those of one day before the operation,and the scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).On the third and seventh day after the operation,the CRP levels of the two groups were higher than those of one day before the operation,and the CRP levels of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was 5.71%(2/35),compared with 11.11%(5/45)in the control group,and the difference was not statistically significant(P>0.05).Conclusion Compared with laparoscopic low rectal cancer resection,laparoscopic low rectal cancer resection without assisted abdominal incision and transanal specimen extraction has longer operation time,shorter postoperative hospital stay,less pain and lower risk of complications.