直肠癌经肛直肠全系膜切除术术后低位前切除综合征的研究  

Low anterior resection syndrome after transanal total mesorectal excision in rectal cancer

作　　者：蒋春晖[1] 刘晔[1] 许春杰[1] 周鸿[1] 徐庆[1] 顾磊[1] Jiang Chunhui;Liu Ye;Xu Chunjie;Zhou Hong;Xu Qing;Gu Lei(Department of Gastrointestinal Surgery,Renji Hospital,School of Medicine Shanghai Jiao Tong University,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院胃肠外科,200127

出　　处：《中华结直肠疾病电子杂志》2021年第6期599-604,共6页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：国家自然科学基金面上项目(No.82072671)。

摘　　要：目的对比taTME与传统腹腔镜(LapTME)对于术后发生LARS的影响,探究taTME手术入路是否加重LARS的发生。方法选取2018年1月~2019年9月期间直肠癌患者,根据手术方式分为taTME组与LapTME组。采集临床参数,围手术期Wexner评分与LARS评分评估肛门功能,术后随访12个月。对比两组间各项参数。结果本研究共纳入80例病例,其中LapTME组40例,taTME组40例。术后3个月,两组患者在Wexner评分差异无统计学意义(P>0.05);taTME组具有更高的LARS得分,但差异无统计学意义(P>0.05)。术后6个月和12个月时,LARS和Wexner评分差异均无统计学意义(P>0.05)。两组患者的Wexner评分和LARS评分均随时间推移得到明显改善。结论taTME可能在术后早期对肛门功能影响更大,而对术后中远期的肛门功能无明显影响。taTME的经肛入路操作不加重LARS的发生。Objective To compare the effect of taTME and LapTME on postoperative LARS,and to explore whether transanal approach aggravates the occurrence of LARS.Methods The patients with rectal cancer from January 2018 to September 2019 were divided into taTME group and LapTME group according to the operation methods.Clinical parameters were collected,and anal function was evaluated by Wexner score and LARS score during perioperative period.All patients were followed up for twelve months.The parameters between the two groups were compared.Results Eighty cases were included,including forty cases in LapTME group and forty cases in taTME group.At three months after operation,there was no significant difference in Wexner score between the two groups(P>0.05).The taTME group had higher LARS score,but there was no significant difference(P>0.05).There was no significant difference in LARS and Wexner scores at six and twelve months after operation(P>0.05).The Wexner score and LARS score of the two groups were significantly improved with time.Conclusions taTME may have a greater impact on anal function in the early postoperative period,but no significant effect in anal function in the middle and long term.The transanal approach does not aggravate the occurrence of LARS.

关 键 词：直肠肿瘤 经肛直肠全系膜切除术 低位前切除综合征 功能学研究 

分 类 号：R735.37[医药卫生—肿瘤]