不同腹部辅助性切口对腹腔镜直肠癌根治术病人肠道功能及生活质量的影响  

Impacts of different abdominal auxiliary incisions on bowel function and quality of life in patients with laparoscopic radical rectal cancer surgery

作　　者：司宇光 吴国庆[1] 袁成龙[1] SI Yuguang;WU Guoqing;YUAN Chenglong(Department of Surgery 1,Beijing Huairou Hospital of Traditional Chinese Medicine,Beijing 101400,China)

机构地区：[1]北京市怀柔区中医医院外一病区,101400

出　　处：《临床外科杂志》2023年第4期353-356,共4页Journal of Clinical Surgery

基　　金：北京市怀柔区中医医院(2020-MP07)。

摘　　要：目的探讨不同腹部辅助性切口对腹腔镜直肠癌根治术病人术后胃肠道功能及生活质量的影响。方法2015年1月~2021年10月我院收治行腹腔镜直肠癌根治术病人180例,根据腹部辅助切口不同将180例病人分为3组,A组60例,采用脐下正中切口;B组60例,采用脐上纵行切口;C组60例,采用左下腹斜行切口。对比3组病人手术相关指标、术后胃肠道功能、术后疼痛评分、术后3天生活质量以及并发症情况。结果A组辅助切口长度长于B组、C组,差异有统计学意义(P<0.05)。与C组相比,A组、B组首次下床活动时间、首次排气时间、肠鸣音恢复时间、疼痛VAS评分以及术后3天胃泌素水平、胃动素水平、生活质量QLQ-CR38量表评分方面具有优势,差异有统计学意义(P<0.05)。A组、B组切口疝发生率低于C组,差异有统计学意义(P<0.05)。结论与左下腹斜行切口相比,脐上纵行切口与脐下正中切口对腹腔镜直肠癌根治术病人的近期疗效肯定,且具有疼痛程度低、生活质量高、肠道功能恢复快等优势。Objective To explore the impacts of different abdominal auxiliary incisions on postoperative gastrointestinal function and quality of life in patients with laparoscopic radical rectal cancer surgery.Methods The clinical data of 180 cases of patients who underwent laparoscopic radical rectal cancer surgery in our hospital from January 2015 to October 2021 were retrospectively analyzed.According to different abdominal auxiliary incisions,60 patients with subumbilical median incision(group A)were randomly selected,and 60 patients with supraumbilical longitudinal incision were selected.Patients(group B),60 patients with oblique incision in the left lower abdomen(group C).The operation-related indicators,postoperative gastrointestinal function,postoperative pain score,postoperative 3-day quality of life,and complications were compared among the three groups.Results The auxiliary incision length in group A was greater than that in groups B and C(P<0.05).Compared with group C,group A and group B had advantages in the time of first getting out of bed,the time of first flatus,the recovery time of bowel sounds,the VAS score of pain,and the levels of gastrin,motilin,and quality of life QLQ-CR38 scale score 3 days after operation,the difference was statistically significant(P<0.05).The incidence of incisional hernia in groups A and B was significantly lower than that in group C,and the difference was statistically significant(P<0.05).Conclusion Compared with the left lower abdominal oblique incision,the supraumbilical longitudinal incision and the subumbilical median incision have positive short-term curative effects in patients with laparoscopic radical rectal cancer surgery,and they have the advantages of lower pain,higher quality of life,and faster recovery of intestinal function.

关 键 词：直肠癌 腹腔镜手术 腹部辅助性切口 疗效 

分 类 号：R735.37[医药卫生—肿瘤]