经腹腔镜直肠癌改良bacon手术对患者术后并发症和复发率的影响  

Impact of laparoscopic modified bacon surgery on postoperative complications and recurrence rate in patients with rectal cancer

作　　者：闫卫甫[1] 王金柱[1] 王方方[1] 赵治国[2] YAN Wei-fu;WANG Jin-zhu;WANG Fang-fang;ZHAO Zhi-guo(Surgery Department,the Second Affiliated Hospital of Luohe Medical College,Luohe,Henan 462300,China;The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471000,China)

机构地区：[1]漯河医学高等专科学校第二附属医院外二科,河南漯河462300 [2]河南科技大学第一附属胃肠外科,河南洛阳471000

出　　处：《医药论坛杂志》2023年第16期69-72,77,共5页Journal of Medical Forum

摘　　要：目的 探讨直肠癌患者应用经腹腔镜直肠癌改良bacon手术对患者术后并发症和复发率的影响。方法 选择2020年4月至2022年4月漯河医学高等专科学校第二附属医院收治的78例直肠癌患者,按照不同的手术方式,分为试验组(39例)和对照组(39例)。对照组经腹腔镜实施直肠系膜切除术,试验组经腹腔镜实施直肠癌改良bacon手术。术前、术后30d,比较两组肛管静息压力,缩窄压,内括约肌长度、大便失禁严重度评分(Wexner)、血清白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)及免疫球蛋白A(IgA),比较围术期相关指标、并发症及复发率。结果 试验组术中出血量比对照组低,差异有统计学意义(P<0.05);试验组进食时间、置管时间、肛门首次排气时间、住院时间比对照组短,差异有统计学意义(P<0.05);术后30 d,两组肛管静息压力、缩窄压、Wexner评分、IL-6、hs-CRP、IgA均降低,且试验组比对照组低,差异有统计学意义(P<0.05);两组内括约肌长度均缩短,且试验组更短,差异有统计学意义(P<0.05);在并发症及复发率方面,试验组(7.69%、0.00%)比对照组低(23.07%、12.82%),差异无统计学意义(P>0.05);术后2年,试验组的疾病复发率(5.13%)比对照组低(25.64%),差异有统计学意义(P<0.05)。结论 直肠癌患者应用经腹腔镜直肠癌改良bacon手术,可减少出血量,改善肛门功能,利于胃肠道功能尽快恢复正常状态,且不会明显影响免疫功能,术后并发症及疾病复发风险小。Objective To investigate the impact of laparoscopic modified Bacon surgery on postoperative complications and recurrence rate in rectal cancer patients.Methods Totally 78 rectal cancer patients admitted to our hospital from April 2020 to April 2022 were selected and divided into an experimental group(39 cases)and a control group(39 cases)according to different surgical methods.The control group underwent laparoscopic mesorectal resection,while the experimental group underwent laparoscopic modified bacon surgery for rectal cancer.Before and 30 days after operation,the anal resting pressure,constriction pressure,internal sphincter length,fecal incontinence severity score(Wexner),serum interleukin-6(IL-6),high-sensitivity C-reactive protein(hs CRP)and immunoglobulin A(IgA)were compared between the two groups,and the perioperative related indicators,complications and recurrence rates were compared.Results The intraoperative bleeding volume in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05);The experimental group had shorter eating time,catheterization time,first anal exhaust time,and hospitalization time compared to the control group,with statistically significant differences(P<0.05);30 days after surgery,the resting pressure,constriction pressure,Wexner score,IL-6,hs CRP,and IgA of the anal canal in both groups decreased,and the experimental group was lower than the control group,with a statistically significant difference(P<0.05);The length of sphincter in the two groups was shorter,and the experimental group was shorter,the difference was statistically significant(P<0.05);In terms of complications and recurrence rates,the experimental group(7.69%,0.00%)was lower than the control group(23.07%,12.82%),and the difference was not statistically significant(P>0.05);Two years after surgery,the disease recurrence rate in the experimental group(5.13%)was lower than that in the control group(25.64%),with a statistically significant difference(P<0.05).C

关 键 词：直肠癌 腹腔镜 改良bacon手术 并发症 复发率 

分 类 号：R735.37[医药卫生—肿瘤]