腹腔镜辅助经肛直肠癌根治术对新辅助放化疗后中低位直肠癌患者的影响  

Effect of Laparoscopic Assisted Radical Resection of Transanal Rectal Cancer on Middle to Low Rectal Cancer Patients after Neoadjuvant Radiotherapy and Chemotherapy

作　　者：刘鑫斌 邓俊晖[2] LIU Xinbin;DENG Junhui(Shantou University Medical College,Shantou 515041,China;不详)

机构地区：[1]汕头大学医学院,广东汕头515041 [2]惠州市中心人民医院

出　　处：《中外医学研究》2023年第20期43-47,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨腹腔镜辅助经肛直肠癌根治术对新辅助放化疗后中低位直肠癌患者的影响。方法:选取2020年7月—2022年11月惠州市中心人民医院收治的97例新辅助放化疗后的中低位直肠癌患者作为研究对象。根据随机数表法将其分为经腹组(n=48)和经肛组(n=49)。经肛组给予腹腔镜辅助经肛直肠癌根治术治疗,经腹组给予腹腔镜直肠癌根治术治疗。比较两组围手术期指标,术前、术后3个月肛门功能、生活质量,术前12 h,术后24 h液体胃排空及小肠传输能力及并发症。结果:经肛组手术时间、住院时间均短于经腹组,术中出血量少于经腹组,术后首次肛门排气时间、术后排便时间均早于经腹组,差异有统计学意义(P<0.05)。术后3个月,经肛组肛管静息压、直肠最大容量(Vmax)、肛管最大收缩压均高于经腹组,差异有统计学意义(P<0.05)。术后24 h,两组柳氮磺胺嘧啶、对乙酰氨基酚曲线下面积(AUC)、峰浓度均下降,但经肛组柳氮磺胺嘧啶、对乙酰氨基酚AUC、峰浓度均高于经腹组,差异有统计学意义(P<0.05)。术后3个月,经肛组社会功能、情感功能、躯体疼痛、精神健康评分均高于经腹组,差异有统计学意义(P<0.05)。经肛组并发症发生率低于经腹组,差异有统计学意义(P<0.05)。结论:腹腔镜辅助经肛直肠癌根治术可改善新辅助放化疗后中低位直肠癌患者的肛门功能,缩短住院时间,减少并发症的发生,促进术后胃肠道功能的恢复,并提高生活质量。Objective:To investigate the effect of laparoscopic assisted radical resection of transanal rectal cancer on middle to low rectal cancer patients after neoadjuvant radiotherapy and chemotherapy.Method:A total of 97 patients with middle and low rectal cancer after neoadjuvant radiotherapy and chemotherapy treated in Huizhou Central People's Hospital from July 2020 to November 2022 were selected as the study objects.They were divided into the transabdominal group(n=48)and the transanal group(n=49)according to random number table method.The transanal group was treated with laparoscopic assisted radical resection of transanal rectal cancer,and the transabdominal group was treated with laparoscopic radical resection of rectal cancer.Perioperative indexes,anal function,quality of life before and 3 months after surgery,fluid gastric emptance,intestinal transport capacity 12 h before and 24 h after surgery and complications were compared between the two groups.Result:The operation time and hospital stay in the transanal group were shorter than those in the transabdominal group,the amount of intraoperative blood loss was less than that in the transabdominal group,and the time of first postoperative anal exhaust and postoperative defecation were earlier than those in the transabdominal group,with statistical significance(P<0.05).At 3 months after surgery,the resting pressure,maximum rectal volume(Vmax)and maximum systolic pressure of anal canal in the transanal group were higher than those in the transabdominal group,and the differences were statistically significant(P<0.05).At 24 h after surgery,the peak concentration and area under curve(AUC)of Sulfadiazine and Paracetamol in the two groups decreased,but the peak concentration and AUC of Sulfadiazine and Paracetamol in the transanal group were significantly higher than those in the transabdominal group,with statistical significance(P<0.05).At 3 months after surgery,the scores of social function,emotional function,physical pain and mental health in the transanal group wer

关 键 词：新辅助放化疗 直肠癌 腹腔镜辅助经肛直肠癌根治术 腹腔镜直肠癌根治术 

分 类 号：R735.37[医药卫生—肿瘤]