不同入路手术治疗直肠癌的效果比较  

Comparison of the effects of different approaches in the treatment of rectal cancer

作　　者：雷林瑜[1] 张俊杰[1] 解寒冰[1] 李文奇[1] Lei Linyu;Zhang Junjie;Xie Hanbing;Li Wenqi(Department of General Surgery,Zhengzhou People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州人民医院普通外科,450000

出　　处：《中国实用医刊》2020年第24期22-25,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较经肛门全直肠系膜切除术(taTME)和传统腹腔镜根治术治疗直肠癌的效果。方法抽取2017年1月至2019年6月郑州人民医院收治的87例直肠癌患者为研究对象,采用随机数字表法分为对照组(44例)及观察组(43例),对照组给予腹腔镜根治术,观察组患者接受taTME治疗;两组患者术后均接受6~12个月随访,比较两组手术及恢复指标、根治性指标(标本长度、淋巴结清扫数目)及并发症情况;并比较两组术前、术后6个月肛门功能。结果87例直肠癌患者均获得随访结果,随访率为100%,随访时间为6~12个月;观察组首次排气时间、下床活动及住院时间均短于对照组(P<0.05);两组根治性指标、手术耗时及术中出血量比较差异未见统计学意义(P>0.05);术后6个月,两组LARS评分均较术前下降,且观察组低于对照组(P<0.05)。结论taTME治疗直肠癌安全可行,根治效果与传统根治术相似,更利于改善患者肛门功能、促进术后恢复,且并发症少。Objective To compare the effects of transanal total mesorectal excision(taTME)and traditional laparoscopic radical resection in rectal cancer.Methods Eighty-seven patients with rectal cancer in Zhengzhou People’s Hospital from January 2017 to June 2019 were selected as the research objects.According to the random number table method,they were divided into control group(n=44)and an observation group(n=43).Patients in the control group received traditional laparoscopic radical resection,and patients in the observation group received taTME treatment;all patients were followed up for 6-12 months after surgery,the surgery and recovery indicators,radical indicators(specimen length,number of lymph node dissection),and the occurrence of postoperative complications of the two groups were compared;the anal function of the two groups before and 6 months after operation was compared.Results All 87 patients with rectal cancer were obtained follow-up results,the follow-up rate was 100%,and the follow-up time was 6-12 months;the first exhaust time,the time to get out of bed,and the length of stay in the observation group were shorter than those of the control group(P<0.05);the radical indicators,operation time and intraoperative blood loss were compared between the two groups,the differences were not statistically significant(P>0.05);6 months after operation,the LARS scores of the two groups were lower than those before the operation,and the observation group was lower than the control group(P<0.05).Conclusions taTME is safe and feasible in the treatment of rectal cancer.Its curative effect is similar to that of traditional radical operation.It is more conducive to improve anal function and promote postoperative recovery,with less complications.

关 键 词：直肠癌 经肛门全直肠系膜切除术 腹腔镜根治术 

分 类 号：R735.37[医药卫生—肿瘤]