单、双吻合器在老年结肠癌患者Dixon术中应用效果的观察  

Observation of single and double stapling technique on Dixon operation in older patients with rectal cancer

作　　者：高增战 李树营 张瑞鹏[3] 

机构地区：[1]陕西省人民医院普外科,陕西西安710068 [2]榆林市横山区人民医院普外科,陕西榆林719700 [3]陕西省人民医院血管外科,陕西西安710068

出　　处：《结直肠肛门外科》2017年第6期734-738,共5页Journal of Colorectal & Anal Surgery

摘　　要：目的比较单、双吻合器用于老年直肠癌患者Dixon术中的效果。方法将本院86例直肠癌行Dixon术的患者随机分为观察组(双器械吻合)与对照组(单器械吻合),每组各43例。比较两组手术相关指标、术中吻合成功率、术后肛门排便功能及并发症发生率,并进行3年期随访观察。结果观察组手术时间短于对照组(P<0.05),两组术中出血量、肠道功能恢复时间、尿管留置时间、住院时间比较差异无统计学意义(P>0.05)。观察组吻合成功率高于对照组(P<0.05)。两组肛门排便功能优良率、并发症发生率比较差异均无统计学意义(均P>0.05)。术后随访3年,两组复发率、转移率差异无统计学意义(P>0.05)。结论双吻合与单吻合用于老年直肠癌Dixon术(TME)在保护肛门功能、减少术后复发转移方面疗效相当,但前者可提高吻合成功率,明显缩短手术时间,对老年患者更有利。Objective To investigate the long-term effect of single stapling and double stapling technique for laparoscopic total mesorectal excision and Dixon anal sphincter preservation in older patients with rectal cancer. Methods A total of 86 rectal cancer patients who underwent mesorectal excision and Dixon anal sphincter preservation in our hospital were randomly assigned to treatment group （double instrument anastomosis） and control group （single instrument anastomosis）, with 43 cases in each group. The operation related indexes, anal defecation function, anastomosis success rate ,incidence complication and long-term survival after 3-year of follow-up were compared between the two groups. Results The rate of conversion to laparotomy was lower in the treatment group than in the control group （P 〈 0.05）. The operation time of the treatment group was shorter than that of the control group （P 〈 0.05）. There was no significant difference between the two groups in the amount of bleeding, the time of bowel function recovery, the indwelling time of the catheter and the length of stay in the hospital （P 〉 0.05）. The successful rate of the treatment group was higher than that of the control group （P 〈 0.05）. There was no significant difference in rate of defecation function, incidence of complication, incidence of recurrent and metastasis at 3-year of follow-up between the two groups （P 〉 0.05）. Conclusion Double anastomosis and single anastomosis are effective in the treatment of laparoscopic rectal cancer with total mesorectal excision and Dixon sphincter preserving surgery for rectal cancer in older patients. It can protect anal function and reduce the rates of recurrence and metastasis.

关 键 词：双吻合 单吻合 老年 直肠癌 DIXON术 

分 类 号：R735.35[医药卫生—肿瘤]