Dixon术与Miles术联合手术室全程干预治疗低位直肠癌的疗效对比研究  

Comparative tudy on the efficacy of Dixon operation and Miles operation combined with operating room intervention in the treatment of low rectal cancer

作　　者：吕连露 张海伟 傅赞 王勇[2] Lianlu LV;HaiWei Zhang;Zan Fu;Yong Wang(Department of anesthesia and perioperative medicine,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of colorectal surgery,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院麻醉与围术期医学科,南京210029 [2]南京医科大学第一附属医院结直肠外科,南京210029

出　　处：《湖南师范大学学报（医学版）》2022年第6期62-66,共5页Journal of Hunan Normal University(Medical Sciences)

基　　金：国家自然科学基金(8217112503)。

摘　　要：目的:分析低位直肠癌前切除术(Dixon术)与腹会阴联合直肠癌根治术(Miles术)联合手术室全程干预对低位直肠癌患者围术期指标、排尿功能、环周切缘(CRM)阳性率、直肠穿孔率、术后复发率、死亡率及并发症发生情况的影响.方法:190例低位直肠癌患者为研究对象,予以随机数字表法将190例患者分为Miles术组(95例)、Dixon术组(95例).Miles术组行Miles术进行治疗,Dixon术组行Dixon术进行治疗,两组术后均观察1年,并于围手术期均予以手术室全程干预.比较Dixon术组、Miles术组围术期指标、术后半年排尿功能、CRM阳性率、术中直肠穿孔率、术后1年复发率、死亡率及术后并发症发生情况.结果:Dixon术组术中失血量、术后引流量少于Miles术组,手术时间、术后首次排气时间短于Miles术组.术后半年,Dixon术组排尿功能1级患者占比(53.68%)高于Miles术组(21.05%),排尿功能3级、4级占比(18.95%、5.26%)低于Miles术组(41.05%、18.95%).Dixon术组、Miles术组CRM阳性率、术中直肠穿孔率、术后1年复发率、死亡率、术后并发症发生率(2.11%vs 3.16%,1.05%vs 2.11%,6.32%vs 7.37%,5.26%vs 8.42%,8.42%vs 3.16%)比较,差异均衡.结论:与Miles术结合手术室全程干预相比,Dixon术结合手术室全程干预可缩短低位直肠癌患者手术时间,减少患者术中出血量、术后引流量,使患者术后肠道功能、排尿功能快速恢复,且具有良好的安全性及远期疗效.Objective Analysis of the effects of anterior resection of low rectal cancer(Dixon operation)and abdominal perineal combined radical resection of rectal cancer(Miles operation)combined with operating room intervention on perioperative indicators,urination function,positive circumferential resection margin(CRM)positive rate,rectal perforation rate,postoperative recurrence rate,mortality and complications in patients with low rectal cancer.Methods A total of 190 patients with low rectal cancer were selected as the research objects,and the 190 patients were divided into the Miles operation group(95 cases)and the Dixon operation group(95 cases)by random number table method.The Miles operation group was treated with Miles operation,and the Dixon operation group was treated with Dixon operation.Both groups were observed for 1 year after operation.In perioperative period,the operating room intervention was performed in both groups.The perioperative indicators,urination function half a year after operation,CRM positive rate,intraoperative rectal perforation rate,recurrence rate 1 year after operation,mortality rate and postoperative complications were compared between the Dixon operation group and the Miles operation group.Results The intraoperative blood loss and postoperative drainage volume in the Dixon group were less than those in the Miles group,and the times of operation and postoperative first exhaust in the Dixon group were shorter than those in the Miles group.Half a year after surgery,the proportion of patients with grade 1 urination function in Dixon operation group(53.68%)was higher than that in Miles operation group(21.05%),and the proportion of patients with grade 3 and 4 urination function in Dixon operation group(18.95% and 5.26%)was lower than that in Miles operation group(41.05% and 18.95%).There were no significant differences in CRM positive rate,intraoperative rectal perforation rate,1 year postoperative recurrence rate,mortality and postoperative complications between the Miles operation group and

关 键 词：低位直肠癌 低位直肠癌前切除术 腹会阴联合直肠癌根治术 手术室全程干预 环周切缘阳性率 

分 类 号：R735.37[医药卫生—肿瘤]