腹腔镜辅助TaTME术与超低温冷冻治疗T_(2-3)N_(0)M_(0)期直肠癌3年疗效比较  

A3-year comparison between laparoscopic assisted TaTME and cryotherapy in patients with T_(2-3)N_(0)M_(0) rectal cancer

作　　者：吉祖进 雷新益 张志云 蒋学军 杨勇 庹磊 严明宇 Ji Zujin;Lei Xinyi;Zhang Zhigrun;Jliang Xuejun;Yang Yong;Chi Lei;Yan Mingyu(Department of Colorectal and Anal Surgery,Dongfeng General Hospital of Chinese Medicine,Shiyan Hubei Province 442008,China;Tianmen First People's Hospital,Tianmen Hubei Province 431700,China)

机构地区：[1]国药东风总医院结直肠肛门外科,湖北十堰442008 [2]天门市第一人民医院,湖北天门431700

出　　处：《中华普外科手术学杂志（电子版）》2022年第4期439-442,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：湖北省卫生健康委员会项目(WJ2019H212)。

摘　　要：目的比较腹腔镜辅助经肛门全直肠系膜切除(TaTME)术与超低温冷冻治疗T_(2-3)N_(0)M_(0)期直肠癌患者的疗效。方法回顾性分析2017年5月至2018年3月收治的63例T_(2-3)N_(0)M_(0)期直肠癌患者的临床资料,根据不同治疗方式分为TaTME术组(n=33例)和超低温组(n=30例),TaTME术组:行腹腔镜辅助TaTME术治疗;超低温组:行超低温冷冻治疗。采用SPSS 23.0软件处理数据,肛门失禁Wexner评分、性生活质量问卷(PISQ)评分以(x±s)表示,独立样本t检验;并发症发生率、排尿功能、治愈率、复发率用[n(%)]表示,行χ^(2)检验。P<0.05为差异有统计学意义。结果两组患者术后1年、3年Wexner评分,排尿功能Ⅱ级、Ⅲ级、Ⅳ级占比,直肠癌治愈率及复发率比较,差异均无统计学意义(P>0.05);超低温组患者术后1年及3年PISQ评分比TaTME术组高,排尿功能Ⅰ级占比较TaTME术组高(P<0.05);超低温组患者并发症发生率比TaTME术组低(P<0.05)。结论腹腔镜辅助TaTME术与超低温冷冻技术治疗T_(2-3)N_(0)M_(0)期直肠癌患者均可保留肛门,治愈率均较高,腹腔镜辅助TaTME术可行淋巴结清扫,超低温冷冻治疗可保护患者性功能和排尿功能,且术后并发症发生率更低。Objective To compare the efficacy of laparnscopie ssted transanal tolal mesorectal excision(TaTME)and crthera in T_(2-3)N_(0)M_(0) rectal cancer patients.Methods The clinical data of 63 patients with T_(2-3)N_(0)M_(0) rectal cancer from May 2017 to March 2018 were retrospectively analyzed.Acording to dfferent treatment methods,the patients were divided into TaTME goup(n=33 cases)and hypothermia group(n=30 cases).TaTME goup:treated with laparoscopic TaTME ureatment;Hyperthermnia goup:treated with underg cryotherapy.SPSS 23.0 software was used to pocess the data.Wexner score of anal incontinence and Pelvic Ogan Prolapse/Urinary Incontinence Sexual Questionnaire(PISQ)score were expressed in(x±s)and independent t test;the incidence of comnplicaions,micturition function,cure rate and recurence rale were expressed by[n(%)],and χ^(2) test were perfomed.P<0.05 was satistically significant.Results There was no satistical significant diference betveen the two groups in Wexner score.urinary function grade Ⅱ、Ⅲ and Ⅳ,cure nate and rcurrence rate of rectal cancer al 1 and 3 years afer operation(P>0.05);the PISQ scores of patients in the ulralow temperature group were higher than those in the TaTME goup al I and 3 years after openation,and the proportion of grade Ⅰ mieturition function was higher than that in the TaTME group(P<0.05);the incidence of complications in the hypothernia group was lower than that in the TaTME group(P<0.05).Conclusion Both laparosopic asted TaTME and cryotherapy can preserve the anus in patients with T_(2-3)N_(0)M_(0) stage rectal cancer,with a high cure rate.Laparoscopic assistod TaTME is feasible for lymph node iscction,and cryotherapy can prtect the sexual function and micturition function of patients with lower complications.

关 键 词：直肠肿瘤 肿瘤分期 经肛门全直肠系膜切除术 超低温冷冻治疗 手术后并发症 

分 类 号：R73[医药卫生—肿瘤]