腹腔镜联合完全内括约肌切除术治疗超低位直肠癌的效果分析  

Analysis of laparoscopic combined with complete intersphincteric resection for ultra-low rectal cancer

作　　者：毛争强 范金阳 杜波涛 Zheng-qiang Mao;Jin-yang Fan;Bo-tao Du(Department of General Oncology,Xinxiang Central Hospital(The Fourth Clinical College of Xinxiang Medical University),Xinxiang,Henan 453600,China)

机构地区：[1]新乡市中心医院(新乡医学院第四临床医院)普瘤一科,河南新乡453600

出　　处：《中国内镜杂志》2022年第1期60-65,共6页China Journal of Endoscopy

摘　　要：目的探讨腹腔镜联合完全内括约肌切除术(ISR)治疗超低位直肠癌的效果。方法回顾性分析2014年4月-2016年7月该院收治的118例超低位直肠癌患者的临床资料,根据手术方法不同分为研究组(n=59)和对照组(n=59)。研究组采用腹腔镜联合完全ISR,对照组采用开腹完全ISR,术后随访3年,总结分析腹腔镜联合完全ISR治疗超低位直肠癌的效果和优势。结果研究组术中出血量较对照组少,术后排气时间和住院时间较对照组短(P<0.05);研究组并发症发生率为11.86%(7/59),较对照组低,肛门功能良好的占比96.61%,较对照组多,两组比较,差异有统计学意义(均P<0.05);两组患者远期效果(局部复发率、远端转移率及死亡率)比较,差异无统计学意义(P>0.05)。结论腹腔镜下完全ISR治疗超低位直肠癌具有并发症少、术中出血量少、术后恢复快、远期效果好的优势,值得临床推广应用。Objective To explore the effect of laparoscopic combined with total intersphincteric resection(ISR)in treatment of ultra-low rectal cancer.Methods Clinical data of 118 patients with ultra-low rectal cancer from April 2014 to July 2016 were retrospectively,and divided into study group(n=59)and control group(n=59)according to different surgical methods.The study group was treated with laparoscopic combined with total ISR,and the control group was treated with open total ISR.The patients were followed up for 3 years to analyze and summarize the effect and advantages of laparoscopic combined with total ISR in the treatment of ultra-low rectal cancer.Results The study group had less bleeding during operation,and the postoperative exhaust time and hospitalization time were shorter(P<0.05).There were 7 patients(11.86%)with complications in the study group,and the proportion of patients with good anal function was 96.61%,there were significantly different with control group(P<0.05).There was no significant difference in long-term effect(local recurrence rate,distant metastasis rate and mortality)between the two groups(P>0.05).Conclusion Laparoscopic total ISR for ultra-low rectal cancer has the advantages of less complications,less intraoperative blood loss,fast postoperative recovery and good long-term effect,which is worthy of clinical application.

关 键 词：腹腔镜技术 完全内括约肌切除术 超低位直肠癌 肛门功能 预后 临床效果 

分 类 号：R735.37[医药卫生—肿瘤]