Overlap吻合术式在腹腔镜结直肠手术重建中的临床研究  

Clinical study of Overlap in laparoscopic colorectal reconstruction

作　　者：孙景毅 张涛 SUN Jingyi;ZHANG Tao(Department of Colon and Rectal Surgery,Longyou County People's Hospital,Longyou 324400,China)

机构地区：[1]龙游县人民医院肛肠外科,浙江龙游324400

出　　处：《全科医学临床与教育》2024年第6期518-521,共4页Clinical Education of General Practice

基　　金：龙游县科技项目(2023072)。

摘　　要：目的研究腹腔镜结直肠手术重建中运用侧侧吻合(Overlap)术式的临床价值。方法选择2022年1月至2023年2月期间龙游县人民医院收治的102例结直肠癌患者为研究对象,均行腹腔镜结直肠癌根治术,以吻合术式不同将其分为两组,其中行功能性端端吻合为对照组(n=51),采用Overlap吻合术式则为观察组(n=51),比较两组患者的围术期指标、炎症指标以及术后并发症发生情况,术后随访12个月,评价两组患者生活质量。结果观察组患者的术后住院、进食、手术以及排气时间均短于对照组,差异均有统计学意义(t分别=5.26、3.49、3.43、3.55,P均<0.05);观察组术后3 d的C反应蛋白(CRP)、白细胞介素-6(IL-6)以及肿瘤坏死因子-α(TNF-α)水平均低于对照组,差异均有统计学意义(t分别=13.14、15.79、12.49,P均<0.05);观察组患者的并发症发生率明显低于对照组,差异有统计学意义(χ^(2)=15.86,P<0.05);两组3、6、9、12个月的生活质量评分比较,差异均无统计学意义(t分别=0.19、0.50、0.60、0.62,P均>0.05)。结论在腹腔镜结直肠癌根治术中,通过采用Overlap吻合术式,不仅可以缩短手术时间,恢复胃肠道功能,还可以减少术后并发症,并且对患者生活质量无明显影响,可以作为有效且安全的一种吻合方式。Objective To study the clinical value of Overlap in laparoscopic colorectal reconstruction.Methods A total of 102 patients with colorectal cancer treated in Longyou County People's Hospital from January 2022 to February 2023 were selected as the study objects,all of whom underwent laparoscopic radical resection of colorectal cancer and were divided into two groups according to different anastomosis methods.Functional end-to-end anastomosis was used in the control group(n=51),and Overlap was used in the observation group(n=51).Perioperative indexes,inflammatory indexes and postoperative complications of the two groups were compared.After 12 months of postoperative follow-up,the quality of life score of the two groups of patients was evaluated.Results The hospitalization,feeding,operation and exhaust time of patients in the observation group were shorter than those in the control group(t=5.26,3.49,3.43,3.55,P<0.05).The levels of C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group 3 days after surgery,with statistical significance(t=13.14,15.79,12.49,P<0.05).The complication rate of observation group was significantly lower than that of control group,the difference was statistically significant(χ^(2)=15.86,P<0.05).After 12 months of follow-up,there was no significant difference in the quality of life scores at 3,6,9 and 12 months between the two groups(t=0.19,0.50,0.60,0.62,P>0.05).Conclusion In laparoscopic radical resection of colorectal cancer,Overlap can not only shorten the operation time,restore gastrointestinal function,but also reduce postoperative complications,and has no significant impact on the quality of life of patients,so it can be used as an effective and safe anastomosis method.

关 键 词：腹腔镜结直肠癌根治术 侧侧吻合 功能性端端吻合 

分 类 号：R735.34[医药卫生—肿瘤]