腹腔镜超低位直肠癌保肛术中经肛加固缝合吻合口的安全性可行性研究

The Safety and Feasibility of Via Anus Reinforcing to Suture Stoma Amidst Laparoscopic Ano-preserved Procedure for Ultra-low Rectal Cancer

目的:探讨腹腔镜超低位直肠癌保肛术中经肛加固缝合吻合口的安全性、可行性。方法:选取2019年7月至2021年7月于我院行腹腔镜超低位直肠癌保肛术的60例患者,随机分为A、B组,各30例。A组术中经肛加固缝合吻合口,B组不经肛加固缝合吻合口。比较2组手术时间、术中出血量、术后肠功能恢复时间、术后肛门功能恢复及吻合口漏发生情况。结果:A组手术时间明显长于B组,P<0.05。2组术中出血量、术后肠功能恢复时间比较差异无统计学意义,P>0.05。2组患者术后肛门功能均逐渐恢复,术后1、3、6、9、12个月各时间点肛门功能良好率比较差异均无统计学意义,P>0.05。A组术后吻合口漏发生率明显低于B组,P<0.05。结论:腹腔镜超低位直肠癌保肛术中经肛加固缝合吻合口虽手术时间有所延长,但有助于降低吻合口漏发生风险,且不影响术后肛门功能恢复,安全可行性高。

Objective To explore the safety and feasibility of via anus reinforcing to suture stoma amidst laparoscopic ano-preserved procedure for ultra-low rectal cancer.Methods Randomly divided 80 patients with ultra-low rectal cancer to be received laparoscopic ano-preserved procedure in authors'hospital(2019-07-2021-07)into group A(30 cases,via anus reinforcing to suture stoma)and group B(30 cases,not received via anus reinforcing to suture stoma);then compared both groups'following indexes:operating time,intraoperative bleeding volume,postoperative time for intestinal function recovered,as well as the status on anal function recovered and stoma leakage emerging.Results In operating time group A was significantly longer than group B(P<0.05);in intraoperative bleeding volume and the time for postoperatively intestinal recovered there was no statistical difference between group A and group B(P>0.05);after surgery,both groups'patients'anal function were gradualy recovered,and at 1,3,6,9,and 12(months)after surgery its good rate between the two groups had no statistical difference(P>0.05);in the incidence of stoma leakage after surgery group A was significantly lower than group B(P<0.05).Conclusion Though operating time is somewhat longer the via anus reinforcing to suture stoma amidst laparoscopic ano-preserved procedure for ultra-low rectal cancer is helpful to decrease the risk of stoma leakage emerging,and no-influencing anal function recovered,and being safe and feasible.