腹腔镜直肠低位前切除术治疗直肠癌的效果及对胃肠蠕动恢复时间的影响  

Therapeutic effect of laparoscopic low anterior resection of the rectum on rectal cancer and its influence on the recovery time of gastrointestinal peristalsis

作　　者：张战坡 张超[2] 白军伟[2] 苏宁亚 谢磊 白雪峰 张晓娜 Zhang Zhanpo;Zhang Chao;Bai Junwei;Su Ningya;Xie Lei;Bai Xuefeng;Zhang Xiaona(Department of General Surgery,No.990 Hospital of the Joint Logistic Support Force,Zhumadian 463000,China;Department of Gastrointestinal Surgery,Henan Provincial People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]联勤保障部队第九九〇医院普外科,驻马店463000 [2]河南省人民医院胃肠外科,郑州450000

出　　处：《中国实用医刊》2024年第11期25-28,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨腹腔镜直肠低位前切除术(LAR)治疗直肠癌的临床效果及对胃肠蠕动恢复时间的影响。方法队列研究。抽取2018年1月至2022年12月联勤保障部队第九九〇医院收治的直肠癌患者68例,按随机数字表法分为开腹组和腹腔镜组,每组34例。开腹组采用开腹LAR治疗,腹腔镜组采用腹腔镜LAR治疗。比较两组围术期指标、术后恢复情况、疼痛程度[视觉模拟评分法(VAS)评分]、肛肠动力学指标及并发症发生率。结果腹腔镜组术中出血量少于开腹组,手术时间、住院天数短于开腹组(P<0.05)。腹腔镜组肛门排气时间、胃肠蠕动恢复时间、进食时间短于开腹组(P<0.05)。术后6、12、24 h,腹腔镜组VAS评分低于开腹组(P<0.05)。术后6个月,腹腔镜组肛管静息压、肛管收缩压高于开腹组(P<0.05)。腹腔镜组并发症发生率(2.94%,1/34)低于开腹组(23.53%,8/34),P<0.05。结论腹腔镜LAR应用于直肠癌患者中可减少出血量,减轻疼痛症状,促进肛门排气和胃肠蠕动,缩短住院时间,且不会影响肛肠动力学,还能降低并发症发生率。Objective To investigate the therapeutic effect of laparoscopic low anterior resection(LAR)of the rectum on rectal cancer and its influence on the recovery time of gastrointestinal peristalsis.Methods A cohort study was adopted in this study.A total of 68 patients with rectal cancer treated in No.990 Hospital of the Joint Logistic Support Force from January 2018 to December 2022 were selected,and they were divided into the open group and the laparoscopic group by random number table method,with 34 cases in each group.The open group was treated by open LAR,and the laparoscopic group was treated by laparoscopic LAR.The perioperative indicators,postoperative recovery,pain severity evaluated by visual analogue scale(VAS)score,anorectal dynamics indicators and incidence of complications were compared between the two groups.Results The intraoperative bleeding in the laparoscopic group was less than that in the open group,while the surgery duration and hospital stay in the laparoscopic group were shorter than those in the open group(P<0.05).The laparoscopic group had shorter anal exhaust time,shorter gastrointestinal peristalsis recovery time,and shorter postoperative eating time compared with the open group(P<0.05).The laparoscopic group had lower VAS scores compared with the open group 6,12 and 24 hours after surgery(P<0.05).The anal resting pressure and anal squeeze pressure in the laparoscopic group were higher than those in the open group 6 months after surgery(P<0.05).The incidence of complications in the laparoscopic group(2.94%,1/34)was lower than that in the open group(23.53%,8/34),P<0.05.Conclusions Laparoscopic LAR can reduce blood loss,relieve pain symptoms,promote anal exhaust and gastrointestinal peristalsis,and shorten hospital stay,without affect on anorectal dynamics;moreover,it can reduce the incidence of complications.

关 键 词：直肠癌 腹腔镜直肠低位前切除术 胃肠蠕动恢复时间 

分 类 号：R735.37[医药卫生—肿瘤]