经肛门吻合器直肠切除术在低位直肠良性肿瘤患者的应用  

Application of stapled transanal rectal mucosal resection in patients with low rectal benign tumors

作　　者：孙会群 马熙 高星 SUN Huiqun;MA Xi;GAO Xing(Department of Anorectal Surgery,Tianjin Hospital,Tianjin 300211,CHINA)

机构地区：[1]天津市天津医院肛肠外科,300211

出　　处：《江苏医药》2024年第7期702-706,共5页Jiangsu Medical Journal

摘　　要：目的观察经肛门吻合器直肠切除术(STARR)在低位直肠良性肿瘤患者中的应用效果。方法86例低位直肠良性肿瘤患者分为观察组(接受STARR,43例)和对照组(接受常规经肛门肿物切除术,43例)。比较两组围手术期指标,术后1、3和7d的VAS疼痛评分,术后3、7和14d的血清炎症因子水平以及肛门直肠血流参数和肛门功能。记录两组术后1个月内并发症发生情况。结果观察组手术时间、术中出血量和住院时间少于对照组,首次排气时间和首次排便时间早于对照组(P<0.05),术后各时间点VAS疼痛评分以及血清IL-6、超敏CRP和TNF-α水平均低于对照组,肛周经皮氧分压、血管血流速度、血流量、肛管舒张压、肛管最大收缩压和肛管静息压高于对照组,肛管高压带长度短于对照组(P<0.05)。观察组术后1个月内并发症发生率低于对照组(P<0.05)。结论低位直肠良性肿瘤患者行STARR有助于肛门功能恢复,能减少术后并发症。Objective To observe the efficacy of stapled transanal rectal mucosal resection(STARR)in the patients with low rectal benign tumors.Methods A total of 86 patients with low rectal benign tumors were divided into two groups of A(received STARR,43 cases)and C(received conventional transanal excision of tumors,43 cases).Perioperative indicators,VAS pain score at 1,3 and 7 days after operation,and serum levels of inflammatory factors,anorectal blood flow parameters and anal function at 3,7 and 14 days after operation were compared between the two groups.The complications within one month after operation were also recorded.Results Compared with group C,group A had less surgical time,intraoperative blood loss and hospital stay and earlier first flatus and defecation times(P<0.05).The VAS pain score and serum levels of IL-6,hypersensitive C-reactive protein and TNF-αwere lower,the perianal transcutaneous oxygen pressure,blood flow velocity,perianal blood flow,anal dilatation pressure,maximum anal canal contraction pressure and resting pressure of the anal canal were higher,and the length of high-pressure zone was shorter in group A than those in group C at each postoperative time point(P<0.05).The incidence of complications within one month after operation was lower in group A than that in group C(P<0.05).Conclusion STARR is beneficial to the recovery of anal function and can reduce postoperative complications in the patients with low rectal benign tumors.

关 键 词：经肛门吻合器直肠切除术 直肠良性肿瘤 肛门功能 

分 类 号：R657[医药卫生—外科学]