腹腔镜经括约肌间切除术治疗超低位直肠癌的疗效及对肛门功能的影响  

Efficacy of laparoscopic intersphincteric resection in the treatment of ultra-low rectal cancer and its impact on anal function

作　　者：卢鑫 赵文召[1] 黄鹏翀[2] LU Xin;ZHAO Wenzhao;HUANG Pengchong(Department of Gastrointestinal Surgery,Kaiyuan Branch,the First Affiliated Hospital of He’nan University of Science and Technology,Luoyang 471000,He’nan,China;Department of Gynaecology,Kaiyuan Branch,the First Affiliated Hospital of He’nan University of Science and Technology,Luoyang 471000,He’nan,China)

机构地区：[1]河南科技大学第一附属医院开元院区胃肠外科,河南洛阳471000 [2]河南科技大学第一附属医院开元院区妇科,河南洛阳471000

出　　处：《癌症进展》2023年第13期1428-1430,1438,共4页Oncology Progress

摘　　要：目的 探讨腹腔镜经括约肌间切除术治疗超低位直肠癌的疗效及对肛门功能的影响。方法 将106例超低位直肠癌患者根据手术方式的不同分为对照组(n=53)和观察组(n=53)。对照组患者采用腹腔镜Dixon术治疗,观察组患者采用腹腔镜经括约肌间切除术治疗。比较两组患者手术相关指标、肛门功能(Wexner评分)、术后并发症发生情况以及预后情况。结果 观察组患者术后首次肛门排气时间、术后住院时间均明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义(P﹤0.01)。出院时和术后半年,观察组患者Wexner评分均明显低于对照组,差异均有统计学意义(P﹤0.01)。两组患者肺部感染、吻合口漏、吻合口狭窄、切口感染、切口愈合不良发生率比较,差异均无统计学意义(P﹥0.05)。术后随访1年,两组患者生存率、复发率比较,差异均无统计学意义(P﹥0.05)。结论 腹腔镜经括约肌间切除术与腹腔镜Dixon术治疗超低位直肠癌可获得相当的疗效,但行腹腔镜经括约肌间切除术患者的肛门功能恢复更快。Objective To investigate the effect of laparoscopic intersphincteric resection for ultra-low rectal cancer and its impact on anal function.Method A total of 106 patients with ultra-low rectal cancer were divided into control group(n=53)and observation group(n=53)according to different surgical methods.The patients in the control group were treated with laparoscopic Dixon operation,and the patients in the observation group were treated with laparoscopic intersphincteric resection.The surgery-related indicators,anal function(Wexner score),postoperative complications,and prognosis were compared between the two groups.Result The postoperative first anal exhaust time and postoperative hospital stay in the observation group were significantly shorter than those in the control group,and the intraoperative blood loss was significantly less than that in the control group,and the differences were statistically significant(P<0.01).At discharge and six months after the operation,the Wexner scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.01).There were no significant differences in the incidence rates of pulmonary infection,anastomotic leakage,anastomotic stenosis,incision infection,and poor incision healing between the two groups(P>0.05).During the one-year follow-up,there were no significant differences in survival and recurrence between the two groups(P>0.05).Conclusion Laparoscopic intersphincteric resection and laparoscopic Dixon operation could achieve comparable curative effects in the treatment of ultra-low rectal cancer,while the recovery of anal function is faster in patients with laparoscopic intersphincteric resection.

关 键 词：超低位直肠癌 腹腔镜经括约肌间切除术 腹腔镜Dixon术 肛门功能 

分 类 号：R735.37[医药卫生—肿瘤]