套袖式吻合技术在腹腔镜超低位直肠癌保肛手术中的安全性、有效性及近期疗效分析  

Safety,Efficacy and Short-term Efficacy of Sleeve Anastomosis in Laparoscopic Anal Preservation Surgery for Ultra-low Rectal Cancer

作　　者：李益明 陈揆龙 刘诗富 LI Yiming;CHEN Kuiong;LIU Shifu(Department of General Surgery,Yong'an Municipal Hospital,Sanming,Fujian Province,366000 China)

机构地区：[1]永安市立医院普外科,福建三明366000

出　　处：《中外医疗》2023年第20期5-9,共5页China & Foreign Medical Treatment

基　　金：2020年度三明市医疗新技术项目(明卫函[2020]130号)。

摘　　要：目的 分析在超低位直肠癌患者腹腔镜手术保肛手术中行套袖式吻合技术的临床价值。方法 随机选取2016年2月—2021年1月永安市立医院收治的50例超低位结直肠癌患者为研究样本,随机均分为观察组(n=25)、对照组(n=25)。对照组患者实施传统腹腔镜下切除吻合术,观察组患者实施腹腔镜袖套袖吻合术,对照两组疗效、手术信息、并发症及手术结局。结果 两组治疗总有效率比较,差异无统计学意义(P>0.05);观察组术中失血量、远端切缘长度显著低于对照组,观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。观察组临时造瘘率与永久造瘘率(4.00%,0)低于对照组(32.00%,24.00%),3年期生存率(84.00%)高于对照组(56.00%),差异有统计学意义(χ^(2)=4.878、4.735、4.667,P<0.05)。结论 在超低位直肠癌患者腹腔镜手术保肛手术中行套袖式吻合技术疗效与常规腹腔镜下手术效能一致,同时其安全性有显著提升,有助于减少肠瘘、造口率,提升患者的术后近中期生存率。Objective To analyze the clinical value of sleeve anastomosis technique in laparoscopic anal preservation in patients with ultra-low rectal cancer.Methods Fifty patients with ultra-low rectal cancer admitted to Yong'an Municipal Hospital from February 2016 to January 2021 were randomly selected as study samples,and were randomly divided into observation group(n=25) and control group(n=25).The control group underwent traditional laparoscopic resection and sleeve anastomosis,and the observation group underwent laparoscopic cuff and sleeve anastomosis.The curative effect,operative information,complications and operative outcome of the two groups were compared.Results The effective rate of the two groups was compared,and the difference was not statistically significant(P>0.05).The intraoperative blood loss and the length of distal incisal margin in the observation group were significantly lower than those in the control group,the complication rete in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The results showed that the temporary and permanent fistula rates in the observation group(4.00%,0) were lower than those in the control group(32.00%,24.00%),the 3-year survival rate of observation group(84.00%) was higher than that of control group(56.00%),and the difference was statistically significant(χ^(2)=4.878,4.735,4.667,P<0.05).Conclusion The efficacy of sleeve anastomosis in laparoscopic anal preservation surgery for patients with ultra-low rectal cancer is consistent with that of conventional laparoscopic surgery,and its safety has been significantly improved,which is helpful to reduce the rate of intestinal fistula and stomy,and improve the postoperative near-medium term survival rate of patients.

关 键 词：套袖吻合 超低位直肠癌 腹腔镜下保肛直肠癌根治术 生存率 

分 类 号：R735.37[医药卫生—肿瘤]