腹腔镜辅助经肛门全直肠系膜切除术对进展期中低位直肠癌患者预后的影响

Effect of Laparoscopic Assisted Transanal Total Mesorectal Excision on the Prognosis of Patients with Advanced Middle and Low Rectal Cancer

【目的】探讨腹腔镜辅助经肛门全直肠系膜切除术对进展期中低位直肠癌患者预后的影响。【方法】本院收治的120例进展期中低位直肠癌患者,根据治疗方法不同分为对照组(n=60,采用全直肠系膜切除术)和观察组(n=60,采用腹腔镜辅助经肛门全直肠系膜切除术)。比较两组患者手术相关指标,术后卡氏功能状态(KPS)评分,并发症发生情况及预后。【结果】与对照组相比,观察组手术时间、术后首次排气时间较短,观察组术中出血量少于对照组(P<0.05)。治疗后,两组患者KPS评分均较治疗前提高,且观察组KPS评分高于对照组(P<0.05)。观察组治疗期间并发症总发生率为5.00%(3/60),低于对照组的16.67%(10/60)(P<0.05)。观察组远处转移率为3.33%(2/60)、局部复发率为1.67%(1/60),均低于对照组的13.33%(8/60)和11.67%(7/60),且两组之间比较,差异均有统计学意义(均P<0.05)。【结论】腹腔镜辅助经肛门全直肠系膜切除术的效果较好,有利于促进进展期中低位直肠癌患者康复,进一步改善其生活质量,降低并发症、远处转移和局部复发发生率。

【Objective】To investigate the effect of laparoscopic assisted total mesorectal excision on the prognosis of patients with advanced middle and low rectal cancer.【Methods】A total of 120 patients with advanced middle and low rectal cancer in our hospital were divided into control group(n=60,total mesorectal excision)and observation group(n=60,laparoscopic assisted total mesorectal excision)according to different treatment methods.Two groups of patients were compared in terms of surgical related indicators,postoperative KPS score,incidence of complications,and prognosis.【Results】Compared with the control group,the observation group had shorter surgical time and first postoperative exhaust time,while the observation group had less intraoperative bleeding than the control group(P<0.05).After treatment,the KPS scores of both groups of patients improved compared to before treatment,and the KPS scores of the observation group were higher than those of the control group(P<0.05).The total incidence of complications during the treatment period in the observation group was 5.00%(3/60),lower than the 16.67%(10/60)in the control group(P<0.05).The distant metastasis rate and local recurrence rate of the observation group were 3.33%(2/60)and 1.67%(1/60),both lower than the control group's 13.33%(8/60)and 11.67%(7/60),and the differences between the two groups were statistically significant(both P<0.05).【Conclusion】Laparoscopic assisted transanal total mesorectal excision has a good effect,which is conducive to promoting the rehabilitation of patients with advanced middle and low rectal cancer,further improving their quality of life,and reducing the incidence of complications,distant metastasis and local recurrence.