经直肠肛门外翻技术与前切除术治疗低位直肠癌的近中期随访比较  

Short-and medium-term follow-up comparison between transrectal eversion and anterior resection for low rectal cancer

作　　者：彭胜建 方锡才 崔巍 Peng Shengjian;Fang Xicai;Cui Wei(Department of Anus and Intestine,Xuancheng People’s Hospital,Xuancheng Anhui Province 242000,China;Department of General Surgery,Xuancheng People’s Hospital,Xuancheng Anhui Province 242000,China)

机构地区：[1]宣城市人民医院,安徽宣城242000 [2]宣城市人民医院普外科,安徽宣城242000

出　　处：《中华普外科手术学杂志（电子版）》2022年第3期335-338,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：安徽省科技厅项目(201904a07020021)。

摘　　要：目的分析经直肠肛门外翻技术与前切除术治疗低位直肠癌的近、中期效果。方法回顾性分析2017年11月至2020年12月93例低位直肠癌患者临床资料,根据手术方式不同,将采用经直肠肛门外翻技术治疗的47例患者纳入外翻组,将采用低位直肠癌前切除术治疗的46例患者纳人前切除组。采用SPSS 23.0软件进行处理数据,手术相关指标、肛门失禁Wexner评分以(x:s)表示,独立样本l检验;并发症发生率肿瘤复发率用百分比表示,用x检验;生存率采用Log-Rank法检验。P<0.05为差异有统计学意义。结果外翻组手术时间术中出血量低于前切除组,远切缘距肿瘤下缘距离大于前切除组(P<0.05);外翻组并发症发生率与前切除组比较,差异无统计学意义(P>0.05);术后6个月,外翻组Wexner评分低于前切除组(P<0.05);两组患者术后1年Wexner评分、1年及3年生存率肿瘤复发率比较,差异无统计学意义(P>0.05)。结论经直肠肛门外翻技术与前切除术治疗低位直肠癌近、中、远期预后相似,但前者手术时间更短,术中出血量更少,更利于达到理想的切缘、控制并发症、促进肛门功能恢复。Objective To analyze the effects of transrectal ectropion technique and anterior resection in the treatment of low rectal cancer.Methods The clinical data of 93 patients with low rectal cancer from November 2017 to December 2020 were retrospectively analyzed.According to different surgical methods,47 patients treated with transrectal anal were included in the valgus group,and 46 patients treated with anterior resection were included in the anterior resection group.SPSS23.0 software was used for processing.Surgery indicators and Wexner score of anal incontinence were expressed as(x±s),independent X^(2) test was performed.The complications and tumor recurrence rate were expressed by percentages Y test is used;the survival rate is tested by the Log-Rank method.P<0.05 was considered statistically significant.Results In Eversion Group,the operation time,intraoperative blood loss were lower than that in anterior resection group,and the distance between distal margin and tumor inferior margin was greater than that of anterior resection group(P<0.05).There was no significant difference in the complication rate between the valgus group and the pre-resection group(P>0.05).6 months after surgery,Wexner score in valgus group was lower than that in preresection group(P<0.05).There were no significant differences in 1-year Wexner score,1-year and 3-year survival rate and tumor recurrence rate between 2 groups(P>0.05).Conclusion The transrectal anal ectropion technique is similar to anterior resection in the near,medium and long-term prognosis,but the former has a shorter operation time and less intraoperative blood loss,better to achieve the ideal margin of resection,control complications,and promote the recovery of anal function.

关 键 词：直肠肿瘤 前切除术 经直肠肛门外翻技术 Wexner评分 疗效比较研究 

分 类 号：R73[医药卫生—肿瘤]