腹腔镜联合完全内括约肌切除术治疗超低位直肠癌的效果分析

Analysis of laparoscopic combined with complete intersphincteric resection for ultra-low rectal cancer

摘要:

目的 探讨腹腔镜联合完全内括约肌切除术（ISR）治疗超低位直肠癌的效果。方法 回顾性分析2014年4月－2016年7月该院收治的118例超低位直肠癌患者的临床资料，根据手术方法不同分为研究组（n = 59）和对照组（n = 59）。研究组采用腹腔镜联合完全ISR，对照组采用开腹完全ISR，术后随访3年，总结分析腹腔镜联合完全ISR治疗超低位直肠癌的效果和优势。结果 研究组术中出血量较对照组少，术后排气时间和住院时间较对照组短（P < 0.05）；研究组并发症发生率为11.86%（7/59），较对照组低，肛门功能良好的占比96.61%，较对照组多，两组比较，差异有统计学意义（均P < 0.05）；两组患者远期效果（局部复发率、远端转移率及死亡率）比较，差异无统计学意义（P > 0.05）。结论 腹腔镜下完全ISR治疗超低位直肠癌具有并发症少、术中出血量少、术后恢复快、远期效果好的优势，值得临床推广应用。

Abstract:

Objective To explore the effect of laparoscopic combined with total intersphincteric resection (ISR) in treatment of ultra-low rectal cancer.Methods Clinical data of 118 patients with ultra-low rectal cancer from April 2014 to July 2016 were retrospectively, and divided into study group (n = 59) and control group (n = 59) according to different surgical methods. The study group was treated with laparoscopic combined with total ISR, and the control group was treated with open total ISR. The patients were followed up for 3 years to analyze and summarize the effect and advantages of laparoscopic combined with total ISR in the treatment of ultra-low rectal cancer.Results The study group had less bleeding during operation, and the postoperative exhaust time and hospitalization time were shorter (P < 0.05). There were 7 patients (11.86%) with complications in the study group, and the proportion of patients with good anal function was 96.61%, there were significantly different with control group (P < 0.05). There was no significant difference in long-term effect (local recurrence rate, distant metastasis rate and mortality) between the two groups (P > 0.05).Conclusion Laparoscopic total ISR for ultra-low rectal cancer has the advantages of less complications, less intraoperative blood loss, fast postoperative recovery and good long-term effect, which is worthy of clinical application.