直肠癌患者腹腔镜下全直肠系膜切除术疗效分析  

Efficacy of Laparoscopic Total Mesorectal Excision for Treatment of Patients with Rectal Cancer

作　　者：钟邦华[1] 李昱骥[1] 孔凡民[1] 

机构地区：[1]中国医科大学附属第一医院胃肠疝外科,沈阳110001

出　　处：《中国医科大学学报》2017年第8期739-741,745,共4页Journal of China Medical University

摘　　要：目的探讨直肠癌患者腹腔镜下全直肠系膜切除术的疗效。方法选取我院2012年3月至2014年3月收治的90例直肠癌患者为研究对象,在患者知情同意基础上分为实验组和对照组。对照组采用开腹全直肠系膜切除术,实验组实施腹腔镜下全直肠系膜切除术,比较2组患者疗效。结果与对照组比较,实验组术中出血量、术后经肛排气时间、术后住院时间、并发症发生率远远低于对照组(P<0.05)。应激指标水平显示,手术前2组患者差异无统计学意义(P>0.05),术后1 d、3 d均增加,但实验组明显低于同时间对照组(P<0.05);术后7 d实验组与术前无统计学差异(P>0.05),而对照组与术前比较差异显著(P<0.05)。结论腹腔镜下全直肠系膜切除术可以降低直肠癌患者并发症的发生率,减弱患者的应激反应,有利于患者术后恢复,具有推广价值。Objective We aimed to investigate the efficacy of laparoscopic total mesorectal excision （TME） for treatment of rectal cancer. Meth- otis We studied 90 patients with rectal cancer admitted to our hospital between March 2012 and March 2014. Patients enrolled for the study were divided into an experimental and control group. The controI group underwent a TME procedure, while laparoscopic TME was performed in the ex- perimental group. Efficacy of procedures performed and stress response indices were compared between the two groups. Results The bleeding vol- ume, postoperative anal exhaust time, and duration of hospitalization were significantly lower in the experimental group than that noted in the con- trol group （P 〈 0.05 ）, as was the incidence of complications （P 〈 0.05）. Assessment of stress indicators showed that the postoperative day 1 （ 1 d） and day 3 （3 d） values were increased in the control group, while the experimental group showed significantly lower values across the same time frame （P 〈 0.05）. Conclusion Laparoscopic TME can reduce the incidence of complications in patients with rectal cancer, and reduce the stress response, which is beneficial for postoperative recovery of patients, and must therefore be promoted as a feasible treatment option in patients with rectal cancer.

关 键 词：腹腔镜 全直肠系膜切除术 直肠癌 应激反应 疗效 

分 类 号：R735.3[医药卫生—肿瘤]