经自然腔道取标本在直肠癌患者腹腔镜根治术中的应用效果  

Application effects of specimen extraction through natural orifice during laparoscopic radical resection on patients with rectal cancer

作　　者：朱大伟 张心意 张林森 ZHU Dawei;ZHANG Xinyi;ZHANG Linsen(The First People’s Hospital of Xiangcheng,Xiangcheng 466200 Henan,China)

机构地区：[1]项城市第一人民医院,河南项城466200

出　　处：《中国民康医学》2023年第2期35-38,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察经自然腔道取标本在直肠癌患者腹腔镜根治术中的应用效果。方法:选取2018年1月至2020年12月该院收治的80例直肠癌患者进行前瞻性研究,按随机数字表法分为对照组和观察组各40例。对照组采用常规腹腔镜根治术治疗,观察组采用腹腔镜根治术中经自然腔道取标本结直肠吻合术治疗。比较两组手术相关指标(手术时间、术中出血量、淋巴结清扫数量、标本完整度、环周切缘阳性)水平、术后康复指标(肠道功能恢复时间、住院时间及术后疼痛)水平、肿瘤细胞播散种植阳性率、复发率和并发症发生率。结果:两组术中出血量、淋巴结清扫数量、标本完整度、环周切缘阳性率比较,差异均无统计学意义(P>0.05);观察组手术时间长于对照组,差异有统计学意义(P<0.05);观察组肠道功能恢复时间、住院时间均短于对照组,差异有统计学意义(P<0.05);两组术后24、48 h VAS评分比较,差异均无统计学意义(P>0.05);两组吻合前、吻合后、手术结束前的肿瘤细胞播散种植阳性率比较,差异均无统计学意义(P>0.05);两组并发症发生率比较,差异无统计学意义(P>0.05);观察组术后1年复发率低于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜根治术中经自然腔道取标本应用于直肠癌患者结直肠吻合术可降低术后1年复发率,缩短肠道功能恢复时间和住院时间的效果优于常规腹腔镜根治术,但需延长手术时间。Objective: To observe application effects of specimen extraction through natural orifice during laparoscopic radical resection on patients with rectal cancer undergoing colorectal anastomosis. Methods: A prospective study was conducted on 80 patients with rectal cancer admitted to the hospital from January 2018 to December 2020. They were divided into control group and observation group according to the random number table method, 40 cases in each. The control group was treated with conventional laparoscopic radical resection, while the observation group was treated with the specimen extraction through natural orifice for the laparoscopic radical resection during colorectal anastomosis. The operation related index levels(operation time, intraoperative blood loss, number of lymph node dissection, positive circumferential resection margin), the postoperative rehabilitation index levels(intestinal function recovery time, hospitalization time and postoperative pain), the pain degree [visual analogue scale(VAS)] score, the positive rate of tumor cell dissemination and seeding, the recurrence rate, and the complication rate were compared between the two groups. Results: There were no significant differences in the intraoperative blood loss, the number of lymph node dissection, the specimen integrity and the positive rate of circumferential margin between the two groups(P>0.05). The operation time of the observation group was longer than that of the control group, and the difference was statistically significant(P<0.05). The intestinal function recovery time and the hospitalization time in the observation group were shorter than those in the control group, and the differences were statistically significant(P<0.05). There were no significant differences in the VAS scores between the two groups 24 and 48 h after the surgery(P>0.05). There were no significant differences in the positive rates of tumor cell dissemination and seeding between the two groups before anastomosis, after anastomosis and before the end of the surge

关 键 词：自然腔道 取标本 结直肠吻合术 直肠癌 腹腔镜根治术 肠道功能 复发率 

分 类 号：R735.37[医药卫生—肿瘤]