腹腔镜下Miles术治疗低位直肠癌患者的远期疗效及其影响因素分析  

Analysis of Long-Term Efficacy and Influencing Factors of Laparoscopic Miles Surgery in Patients with Low Rectal Cancer

作　　者：赵科斌 赵德文 杨含腾[2] ZHAO Kebin;ZHAO Dewen;YANG Hanteng(Department of General Surgery,Jingtai County Traditional Chinese Medicine Hospital,Baiyin 730900,China;Department of General Surgery,Second Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]甘肃省景泰县中医医院普外科,甘肃白银730900 [2]兰州大学第二医院普外科,甘肃兰州730000

出　　处：《中国伤残医学》2025年第7期51-54,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨腹腔镜下Miles术治疗低位直肠癌患者的远期疗效并分析及其影响因素。方法:回顾性分析2020年4月—2021年4月景泰县中医医院及兰州大学第二医院收治的120例低位直肠癌患者资料,所有患者均采取腹腔镜下Miles术治疗。统计随访3年的癌症复发或远处转移情况,根据是否复发或远处转移将其分疗效好组(n=89)和疗效差组(n=31)。收集患者资料,包括性别(男、女)、年龄(≥60岁、<60岁)、身体质量指数(≥24 kg/m^(2)、<24 kg/m^(2))、文化程度(高中及以下、专科及以上)、婚姻状况(在婚、未婚或离异)、肿瘤直径(≥5cm、<5cm)、肿瘤分化程度(低分化、中分化/高分化)、是否接受新辅助化疗(否、是)、胚癌抗原水平(≥13.6 U/L、<13.6 U/L)、淋巴结转移数目(≥4个、<4个)。对影响腹腔镜下Miles术治疗低位直肠癌患者效果的相关因素进行分析。结果:120例患者中癌症复发17例,复发率14.17%;癌症远处转移14例,转移率为11.67%。单因素分析显示,肿瘤直径、肿瘤分化程度、是否接受新辅助化疗、胚癌抗原水平、淋巴结转移数目是腹腔镜下Miles术治疗低位直肠癌患者的影响因素(P<0.05)。Logistic回归分析显示,肿瘤直径≥5cm、肿瘤分化程度为低分化、未接受新辅助化疗、胚癌抗原水平≥13.6 U/L、淋巴结转移数目≥4个是影响低位直肠癌腹腔镜下Miles术患者远期疗效的独立危险因素(P<0.05)。结论:腹腔镜下Miles术治疗低位直肠癌的远期疗效是否理想,与肿瘤直径≥5cm、肿瘤分化程度为低分化、未接受新辅助化疗、胚癌抗原水平≥13.6 U/L、淋巴结转移数目≥4个的独立危险因素有关。Objective:To investigate the long-term efficacy and influencing factors of laparoscopic Miles surgery in patients with low rectal cancer.Methods:The data of 120 patients with low rectal cancer admitted to Jingtai County Hospital of Traditional Chinese Medicine and the Second Hospital of Lanzhou University from April 2020 to April 2021 were retrospectively analyzed.All patients were treated with Miles laparoscopic surgery.The recurrence or distant metastasis of cancer during 3-year follow-up were analyzed and divided into good treatment group(n=89)and poor treatment group(n=31)according to whether there was recurrence or distant metastasis.Data of patients were collected,including gender(male,female),age(≥60 years old,<60 years old),body mass index(≥24 kg/m^(2),<24 kg/m^(2)),education level(high school and below,college or above),marital status(in marriage,unmarried or divorced),tumor diameter(≥5 cm,<5 cm),the degree of tumor differentiation(low differentiation,medium differentiation/high differentiation),whether neoadjuvant chemotherapy was received(no,yes),the level of embryonic cancer antigen(≥13.6 U/L,<13.6 U/L),and the number of lymph node metastasis(≥4,<4).The factors influencing the efficacy of laparoscopic Miles in the treatment of low rectal cancer were analyzed.Results:Among the 120 patients,17 cases of cancer recurred,the recurrence rate was 14.17%;14 cases had distant metastasis,the metastasis rate was 11.67%.Univariate analysis showed that tumor diameter,tumor differentiation degree,whether receiving neoadjuvant chemotherapy,embryonic cancer antigen level,and the number of lymph node metastases were influencing foctors of the efficacy of laparoscopic miles surgery in patients with low rectal cancer(P<0.05).Logistic regression analysis showed that tumor diameter≥5 cm,poorly differentiated tumor degree,no neoadjuvant chemotherapy,embryonic cancer antigen level≥13.6 U/L,and number of lymph node metastasis≥4 were independent risk factors affecting the long-term efficacy of patients undergo

关 键 词：低位直肠癌 腹腔镜下Miles术 远期疗效 影响因素 

分 类 号：R61[医药卫生—外科学]