腹腔镜辅助下结直肠外翻托出式手术治疗结直肠癌的临床观察  

Clinical Observation on the Treatment of Colorectal Cancer with Laparoscopically Assisted Colorectal Ectropion Surgery

作　　者：杨春[1] 张春霞[1] 姜涛[1] YANG Chun;ZHANG Chunxia;JIANG Tao(Shenyang Anorectal Hospital,Liaoning Shenyang 110002,China)

机构地区：[1]辽宁省沈阳市肛肠医院肛肠外科,辽宁沈阳110002

出　　处：《河北医学》2021年第7期1174-1178,共5页Hebei Medicine

基　　金：辽宁省科学技术厅自然科学基金指导计划项目,(编号:20170540840)。

摘　　要：目的:研究腹腔镜辅助下结直肠外翻拖出式手术治疗结直肠癌的特点,为优化术式以及相关研究提供参考。方法:前瞻性选取沈阳市肛肠医院2018年7月至2020年7月期间收治的66例结直肠癌患者,依据简单随机分组法将66例患者分为试验组(n=33例)与对照组(n=33例)。对照组对患者行腹腔镜直肠前切除术,试验组对患者行腹腔镜下结直肠外翻拖出式手术。两组均于术后5d评估其治疗效果,观察比较两组手术指标(术中出血量、手术时间、日均排便次数、肠道恢复时间以及住院时间)、复发率及并发症发生率。结果:试验组患者术后日均排便次数为(9.62±1.22)次,明显多于对照组的(5.22±0.80)次,差异有统计学意义(t=8.032,P<0.05);两组手术时间对比[(157.23±43.42)min vs(163.04±40.45)min],差异无统计学意义(t=0.074,P>0.05);试验组术后肠道恢复时间[(2.11±0.50)d]、术中出血量[(46.32±4.27)mL]以及住院时间[(48.44±3.50)d],均明显短或者少于对照组的[(4.58±0.68)d]、[(68.42±6.57)mL]、[(67.90±5.91)d],差异有统计学意义(t=7.540、6.279、7.097,P<0.05);试验组患者等切口感染、术后吻合口瘘、腹腔出血以及皮下气肿等并发症发生率均明显低于对照组,差异有统计学意义(P<0.05);试验组患者术后5个月的复发率明显低于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜下结直肠外翻拖出式手术治疗具有创伤小等优点且可以显著降低患者术后复发率及各并发症发生率,缩短住院时间,具有推广价值。Objective:To study the characteristics of laparoscopic-assisted colorectal ectropion and drag-out surgery for colorectal cancer,and to provide references for optimizing surgical procedures and related research.Methods:66 colorectal cancer patients who were treated in Shenyang anal and intestinal hospital from July 2018 to July 2020 were selected prospectively.66 patients were divided into experimental group(n=33)and control group(n=33 cases)according to simple random grouping method.The control group performed laparoscopic rectectomy,and the experimental group performed laparoscopic colorectal ectropion and pull out operation.The therapeutic effect of the two groups was evaluated 5 days after operation,and the operation indexes(bleeding,operation time,defecation times per day,intestinal recovery time and hospitalization time),recurrence rate and complication rate were observed and compared.Results:The average daily defecation times in experimental group was(9.62±1.22)times,which was significantly higher than that in control group(5.22±0.80)times,the difference was statistically significant(t=8.032,P<0.05).Comparison of operation time between the two groups[(157.23±43.42)min vs(163.04±40.45)min],the difference was not statistically significant(t=0.074,P>0.05).The postoperative intestinal recovery time[(2.11±0.50)d],intraoperative blood loss[(46.32±4.27)ml]and hospitalization time[(48.44±3.50)d]in experimental groups were significantly shorter or shorter than those in control group[(4.58±0.68)d],[(68.42±6.57)ml]and[(67.90±5.91)d],with statistical significance(t=7.540,6.279,7.097,P<0.05).The incidence of complications such as equincisional infection,postoperative anastomotic fistula,abdominal hemorrhage and subcutaneous emphysema in experimental group was significantly lower than that in control group,with statistical significance(P<0.05).The recurrence rate of 5 months after operation in experimental group was significantly lower than that in control group,with statistical significance(P<0.05).Conclusion:

关 键 词：结直肠癌 腹腔镜 结直肠外翻拖出式 手术指标 并发症 复发率 

分 类 号：R735.34[医药卫生—肿瘤]