腹腔镜下直肠经肛门拖出式手术与直肠前切除术对低位直肠癌的效果研究
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摘要
目的对比腹腔镜下直肠经肛门拖出式手术与直肠前切除术对低位直肠癌的效果。方法 62例低位直肠癌患者,随机分为对照组与观察组,每组31例。对照组采用腹腔镜下直肠前切除手术治疗,观察组采用腹腔镜下直肠经肛门拖出式手术治疗,对比两组患者手术情况(手术时间、术中出血量、清扫淋巴结数量以及住院时间)及复发情况。结果观察组患者手术时间和住院时间均短于对照组,术中出血量少于对照组,清扫淋巴结数量多于对照组,差异具有统计学意义(P<0.05)。观察组患者复发率为6.5%,显著低于对照组的29.0%,差异具有统计学意义(P<0.05)。结论低位直肠癌患者采用腹腔镜下直肠经肛门拖出式手术治疗,可以缩短手术时间以及住院时间,减少出血量,增加清扫淋巴结数量,降低复发率,值得临床推广应用。
Objective To compare the effect of laparoscopic transanal pull-out surgery and anterior rectal resection for low rectal cancer. Methods A total of 62 low rectal cancer patients were randomly divided into control group and observation group, with 31 cases in each group. The control group received laparoscopic anterior rectal resection, and the observation group received laparoscopic transanal pull-out surgery. The surgical situation(operation time, intraoperative bleeding volume, number of lymph nodes dissected) and recurrence situation between the two groups was compared. Results The observation group had shorter operation time and hospitalization time than the control group, less intraoperative bleeding volume than the control group, and more number of lymph nodes dissected than the control group. Their difference was statistically significant(P<0.05). The observation group had significantly lower recurrence rate as 6.5% than 29.0% in the control group, and the difference was statistically significant(P<0.05). Conclusion Laparoscopic transanal pull-out surgery for low rectal cancer can shorten the operation time and hospitalization time, reduce the amount of bleeding, increase the number of lymph nodes dissected and reduce the recurrence rate. It is worthy of clinical promotion and application.
Objective To compare the effect of laparoscopic transanal pull-out surgery and anterior rectal resection for low rectal cancer. Methods A total of 62 low rectal cancer patients were randomly divided into control group and observation group, with 31 cases in each group. The control group received laparoscopic anterior rectal resection, and the observation group received laparoscopic transanal pull-out surgery. The surgical situation(operation time, intraoperative bleeding volume, number of lymph nodes dissected) and recurrence situation between the two groups was compared. Results The observation group had shorter operation time and hospitalization time than the control group, less intraoperative bleeding volume than the control group, and more number of lymph nodes dissected than the control group. Their difference was statistically significant(P<0.05). The observation group had significantly lower recurrence rate as 6.5% than 29.0% in the control group, and the difference was statistically significant(P<0.05). Conclusion Laparoscopic transanal pull-out surgery for low rectal cancer can shorten the operation time and hospitalization time, reduce the amount of bleeding, increase the number of lymph nodes dissected and reduce the recurrence rate. It is worthy of clinical promotion and application.
引文
[1]梁平.腹腔镜下直肠低位前切除术与直肠经肛门拖出切除术治疗直肠癌的效果比较.中华普外科手术学杂志(电子版), 2018(1):46-48.
[2]张永康,张剑,廖晓锋.腹腔镜下直肠经肛门拖出式手术与直肠前切除术治疗低位直肠癌的比较.中国微创外科杂志, 2016,16(8):736-739.
[3]赵泽峰,杨之斌.经肛门拖出式全腔镜直肠前切除术治疗中低位直肠癌效果观察.山东医药, 2017, 57(34):53-55.
[4]林恒军,邱学科,袁航.经肛拖出式全腹腔镜直肠癌前切除在直肠癌患者中的临床价值.中国内镜杂志, 2017, 23(1):1-5.
[5]刘红波,杨安,冯运章,等.男性低位直肠癌患者腹腔镜下全直肠系膜切除联合直肠经肛门拖出式吻合术的治疗体会.中国普外基础与临床杂志, 2010, 17(11):1179-1182.
[6]李鹏胜,向国安,肖方联,等.低位直肠癌腹腔镜辅助下经肛门拖出式吻合保肛术的临床研究.腹部外科, 2008, 21(1):24-25.
[7]向华.腹腔镜下直肠经肛门拖出式手术与直肠前切除术治疗低位直肠癌的比较.心理医生, 2017, 23(16):63-64.
[8]张宜江.经肛拖出式全腹腔镜直肠前切除术在中低位直肠癌中的应用体会.结直肠肛门外科, 2017, 23(2):170-173.
[9]姚寒晖.经肛拖出式全腹腔镜直肠前切除同腹腔镜辅助直肠前切除对比研究.安徽医科大学, 2014.
[10]陈丹,胡丰良,黄丹丹,等.经双吻合器直肠拖出式切除吻合行超低位直肠癌保肛术的疗效评价.结直肠肛门外科, 2013,19(1):9-12.
[11]张国虎,薛刚,曹永宽,等.经肛门拖出式切除并双吻合器技术在超低位直肠癌保肛术中的应用.西南军医, 2008, 10(4):64-65.
[2]张永康,张剑,廖晓锋.腹腔镜下直肠经肛门拖出式手术与直肠前切除术治疗低位直肠癌的比较.中国微创外科杂志, 2016,16(8):736-739.
[3]赵泽峰,杨之斌.经肛门拖出式全腔镜直肠前切除术治疗中低位直肠癌效果观察.山东医药, 2017, 57(34):53-55.
[4]林恒军,邱学科,袁航.经肛拖出式全腹腔镜直肠癌前切除在直肠癌患者中的临床价值.中国内镜杂志, 2017, 23(1):1-5.
[5]刘红波,杨安,冯运章,等.男性低位直肠癌患者腹腔镜下全直肠系膜切除联合直肠经肛门拖出式吻合术的治疗体会.中国普外基础与临床杂志, 2010, 17(11):1179-1182.
[6]李鹏胜,向国安,肖方联,等.低位直肠癌腹腔镜辅助下经肛门拖出式吻合保肛术的临床研究.腹部外科, 2008, 21(1):24-25.
[7]向华.腹腔镜下直肠经肛门拖出式手术与直肠前切除术治疗低位直肠癌的比较.心理医生, 2017, 23(16):63-64.
[8]张宜江.经肛拖出式全腹腔镜直肠前切除术在中低位直肠癌中的应用体会.结直肠肛门外科, 2017, 23(2):170-173.
[9]姚寒晖.经肛拖出式全腹腔镜直肠前切除同腹腔镜辅助直肠前切除对比研究.安徽医科大学, 2014.
[10]陈丹,胡丰良,黄丹丹,等.经双吻合器直肠拖出式切除吻合行超低位直肠癌保肛术的疗效评价.结直肠肛门外科, 2013,19(1):9-12.
[11]张国虎,薛刚,曹永宽,等.经肛门拖出式切除并双吻合器技术在超低位直肠癌保肛术中的应用.西南军医, 2008, 10(4):64-65.