经肛全直肠系膜切除术的临床效果研究  

Clinical Value of Transanal Total Mesorectal Resection for Rectal Cancer

作　　者：王韬 武健[1] Wang Tao;Wu Jian(Department of Gastroenterology,Yijishan Hospital,Wannan Medical College Abstract)

机构地区：[1]皖南医学院弋矶山医院胃肠外科,241000

出　　处：《长治医学院学报》2020年第1期48-51,共4页Journal of Changzhi Medical College

摘　　要：目的:探讨经腹经肛全直肠系膜切除术在低位直肠癌患者手术中的临床应用效果。方法:回顾性收集80例中低位直肠癌患者,其中40例行经肛门内窥镜手术入路(TaTME)术式(观察组),40例行传统腔镜手术(对照组),比较2组患者的术中情况、术后早期肠道功能恢复、并发症、术后1年内回访生存情况。结果:2组近远端切缘长度、切缘残癌率、清扫淋巴结数目差异无统计学意义(P>0.05);观察组手术时长(240.80±38.40)min长于对照组的(182.60±24.30)min,观察组出血量(53.41±14.46)mL少于对照组的(59.28±12.67)mL,观察组术后排气时间(2.80±0.60)d短于对照组的(3.10±1.20)d,术后首次下床活动时间(2.60±1.50)d短于对照组的(5.20±1.30)d,差异均有统计学意义(P<0.05);2组术后1年随访生存率方面差异无统计学意义(P>0.05)。结论:TaTME术式对于中低位直肠癌患者,可减少手术出血量,加快术后早期功能恢复。Objective:To compare the clinical application value of transabdominal transanal total mesorectal resection and traditional laparoscopic total mesorectal resection in the operation of patients with middle and low rectal cancer.Methods:A total of 80 patients with middle and low rectal cancer were retrospectively collected,involving 40 patients of transanal total mesorectal excision(TaTME)(observation group)and 40 traditional laparoscopic surgery(control group).The intraoperative conditions,early postoperative intestinal function recovery,complications and return visit for survival within one year after operation were compared between the two groups.Results:There was no significant difference between the two groups in the length of proximal and distal resection margin,the residual cancer rate of resection margin and the number of lymph nodes dissected.Compared with the control group,the operation time in the observation group(240.80±38.40)min was longer than that in the control group(182.60±24.30)min,and the intraoperative bleeding in the observation group(53.41±14.46)mL was less than that in the control group(59.28±12.67)mL;the first postoperative exhaust time[(2.80±0.60)d vs.(3.10±1.20)d]and the first postoperative ambulation time([(2.60±1.50)d vs.(5.20±1.30)]d)in the observation group were shorter than that in the control group(P<0.05).There was no significant difference in the one-year follow-up survival rate between the two groups(P>0.05).Conclusion:Compared with traditional laparoscopic total mesorectal resection,TaTME has more advantages in surgical hemorrhage and early postoperative recovery of patients with middle and low rectal cancer.

关 键 词：全直肠系膜切除术 腹腔镜 经肛 直肠癌 

分 类 号：R657.1[医药卫生—外科学]