中低位直肠癌行保肛手术术后吻合口效果的临床分析
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摘要
目的探讨临床中低位直肠癌患者应用全直肠系膜切除联合国产双吻合器保肛术方案治疗效果及对吻合口瘘的防范作用。方法 40例中低位直肠癌患者,随机分为对照组(18例)和观察组(22例)。对照组采用传统经腹会阴联合直肠癌切除术治疗,观察组采用全直肠系膜切除联合国产双吻合器保肛术治疗。比较两组患者的手术时间、术中出血量、术后吻合口瘘发生情况及术后1年复发情况。结果观察组患者手术时间明显短于对照组,术中出血量明显少于对照组,差异具有统计学意义(P<0.05)。观察组术后吻合口瘘发生率4.5%和术后1年复发率4.5%均显著低于对照组的27.8%和33.3%,差异具有统计学意义(P<0.05)。结论中低位直肠癌患者应用全直肠系膜切除联合国产双吻合器保肛术治疗,可显著改善手术质量,防范吻合口瘘,降低复发率。
Objective To investigate the clinical effect of total mesorectal excision combined with home-made double stapler anus preserving surgery for middle and low rectal cancer and its prevention effect of anastomotic leakage in the clinical. Methods A total of 40 patients with middle and low rectal cancer were randomly divided into control group for 18 cases and observation group for 22 cases. The control group was treated with traditional transabdominal perineal resection combined with rectal cancer resection, the observation group was treated with total mesorectal excision combined with home-made double stapler anus preserving surgery. The operative time, intraoperative blood loss, postoperative anastomotic leakage and recurrence after 1 year were compared between the two groups. Results The operative time of the observation group was significantly shorter than that of the control group, and the intraoperative blood loss of the observation group was significantly less than that of the control group, the differences were statistically significant(P<0.05). The incidence of anastomotic leakage and the recurrence rate in the observation group were 4.5% and 4.5% respectively, which were significantly lower than 27.8% and 33.3% in the control group, the differences were statistically significant(P<0.05). Conclusion The application of total mesorectal excision combined with home-made double stapler anus preserving surgery for middle and low rectal cancer can significantly improve the quality of surgery, prevent anastomotic fistula and reduce the recurrence rate.
Objective To investigate the clinical effect of total mesorectal excision combined with home-made double stapler anus preserving surgery for middle and low rectal cancer and its prevention effect of anastomotic leakage in the clinical. Methods A total of 40 patients with middle and low rectal cancer were randomly divided into control group for 18 cases and observation group for 22 cases. The control group was treated with traditional transabdominal perineal resection combined with rectal cancer resection, the observation group was treated with total mesorectal excision combined with home-made double stapler anus preserving surgery. The operative time, intraoperative blood loss, postoperative anastomotic leakage and recurrence after 1 year were compared between the two groups. Results The operative time of the observation group was significantly shorter than that of the control group, and the intraoperative blood loss of the observation group was significantly less than that of the control group, the differences were statistically significant(P<0.05). The incidence of anastomotic leakage and the recurrence rate in the observation group were 4.5% and 4.5% respectively, which were significantly lower than 27.8% and 33.3% in the control group, the differences were statistically significant(P<0.05). Conclusion The application of total mesorectal excision combined with home-made double stapler anus preserving surgery for middle and low rectal cancer can significantly improve the quality of surgery, prevent anastomotic fistula and reduce the recurrence rate.
引文
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[3]黄锦远,姜杰,钟穗斌,等.国产双吻合器在低位直肠癌切除保肛中的应用价值.中国现代药物应用,2017,11(9):58-59.
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[6]王永兵,赵晓晖,罗芸宝,等.肛门括约肌肌电图检测对直肠癌保肛手术患者术后肛门功能评价的意义.生物医学工程与临床,2016,17(3):22-23.
[7]刘江,李彦卿,郑海军,等.预防性回肠造瘘联合腹膜外引流对低位直肠癌保肛手术术后生活质量及肛门功能的影响.山西医药杂志,2016,12(2):25-26.
[8]方艺聪,曾群章,姚开源,等.腹腔镜经肛内括约肌技术联合外翻技术在超低位直肠癌保肛手术中的应用.中外医学研究,2016,10(2):21-22.
[2]刘秋华,张伯,涂建成,等.双器械吻合联合全直肠系膜切除Dixon保肛手术治疗直肠癌的临床效果观察.中国现代医学杂志,2016,26(10):99-102.
[3]黄锦远,姜杰,钟穗斌,等.国产双吻合器在低位直肠癌切除保肛中的应用价值.中国现代药物应用,2017,11(9):58-59.
[4]马骏,冯勇,丛进春,等.低位直肠癌保肛术后的吻合口水平对排便功能及生活质量的影响.世界华人消化杂志,2009,17(2):221-224.
[5]魏广辉,王振军,高志刚,等.经肛门切除内括约肌治疗超低位直肠癌的保肛手术47例临床经验.中华普外科手术学杂志(电子版),2009,15(2):18-19.
[6]王永兵,赵晓晖,罗芸宝,等.肛门括约肌肌电图检测对直肠癌保肛手术患者术后肛门功能评价的意义.生物医学工程与临床,2016,17(3):22-23.
[7]刘江,李彦卿,郑海军,等.预防性回肠造瘘联合腹膜外引流对低位直肠癌保肛手术术后生活质量及肛门功能的影响.山西医药杂志,2016,12(2):25-26.
[8]方艺聪,曾群章,姚开源,等.腹腔镜经肛内括约肌技术联合外翻技术在超低位直肠癌保肛手术中的应用.中外医学研究,2016,10(2):21-22.