腹腔镜直肠全系膜切除术治疗中低位直肠癌患者的效果

Effects of laparoscopic total mesorectal excision in treatment of patients with middle and low rectal cancer

目的:观察腹腔镜直肠全系膜切除术(TME)治疗中低位直肠癌患者的效果。方法:选取2019年7月至2021年7月该院收治的78例中低位直肠癌患者进行前瞻性研究,按照随机数字表法分为研究组与对照组各39例。对照组予以开腹TME治疗,研究组予以腹腔镜TME治疗,比较两组临床疗效、术后视觉模拟评分法(VAS)评分、手术指标(术中出血量、手术时间)水平、术后恢复指标(术后首次肛门排气时间、术后首次进食时间、住院时间)水平和并发症发生率。结果:研究组治疗总有效率为94.87%,高于对照组的76.92%,差异有统计学意义(P<0.05);术后6、12、24 h,研究组VAS评分均低于对照组,差异有统计学意义(P<0.05);研究组手术时间、术后肛门排气时间、术后首次进食时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为5.13%,明显低于对照组的20.51%,差异有统计学意义(P<0.05)。结论:腹腔镜TME治疗中低位直肠癌患者可提高治疗总有效率,减少术中出血量,降低术后VAS评分和并发症发生率,缩短手术时间、术后肛门排气时间、术后首次进食时间、住院时间,效果优于开腹TME。

Objective:To observe effects of laparoscopic total mesorectal excision(TME)in treatment of patients with middle and low rectal cancer.Methods:A prospective study was conducted on 78 patients with middle and low rectal cancer admitted to this hospital from July 2019 to July 2021.They were divided into study group and control group according to the random number table method,39 cases in each group.The control group was treated with open TME,while the study group was treated with laparoscopic TME.The clinical efficacy,the postoperative visual analogue scale(VAS)score,the operation index levels(intraoperative blood loss,operation time),the postoperative recovery index levels(postoperative first anal exhaust time,postoperative first feeding time,hospitalization time),and the complication rate were compared between the two groups.Results:The total effective rate of treatment in the study group was 94.87%,which was higher than 76.92% in the control group,and the difference was statistically significant(P<0.05).6,12 and 24 h after the operation,the VAS scores of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).The operation time,the postoperative anal exhaust time,the postoperative first feeding time and the hospitalization time of the study group were shorter than those of the control group;the intraoperative blood loss was lower than the control group;and the differences were statistically significant(P<0.05).Further,the complication rate in the study group was 5.13%,which was significantly lower than 20.51%in the control group,the difference was statistically significant(P<0.05).Conclusions:Laparoscopic TME for the patients with middle and low rectal cancer can improve the total effective rate of treatment,reduce the intraoperative blood loss,the postoperative VAS scores and the complication rate,and shorten the operation time,the postoperative anal exhaust time,the postoperative first feeding time and the hospitalization time.Moreover,it is superior to open TME.