摘要
目的探讨腹腔镜下改良Bacon’s直肠癌根治术对低位直肠癌患者术后肛门功能及远期疗效的影响。方法回顾性分析2012年1月至2013年10月收治的低位直肠癌患者63例,按术式分组,其中30例行改良Bacon’s直肠癌根治术患者为A组,33例行腹腔镜下双吻合器术直肠前切除术患者为B组。采用SPSS20.0软件进行统计学分析。术后排便能力、并发症发生率采用χ2检验;术中术后各项指标以(x±s)描述,独立样本t检验;累积生存率比较应用Log-Rank检验,均采用双侧检验,P<0.05差异有统计学意义。结果两组术中失血量、手术时间、淋巴结清扫数量、术后3个月及12个月时排便能力、并发症发生率及住院时间比较差异无统计学意义(P>0.05),但A组术后肠功能恢复时间较B组短(P<0.05);术后6个月时排便优良率显著优于B组(χ2=4.237,P=0.039),住院费用显著低于B组(t=8.290,P=0.000);经Kaplan-Meier生存分析显示,两组累积生存率分别为83.3%、84.8%,差异无统计学意义(χ2=0.001,P=0.969)。结论低位直肠癌患者腹腔镜下行改良Bacon’s直肠癌根治术或行双吻合器术直肠前切除术,在并发症、生存率上无明显差异,但前者术后肠道功能恢复及排除能力改善更显著,值得临床重视。
Objective To observe the long-term outcome and postoperative anal function after laparoscopic modified Bacon’s radical resection of rectal cancer. Methods A retrospective analysis was performed in 63 patients with low rectal cancer from January 2012 to October 2013, who were divided into groups according to surgical methods. Among them, 30 patients receiving modified Bacon’s radical resection of rectal cancer were in group A, and 33 patients receiving laparoscopic double-stapler prerectal resection were in group B. Statistical analysis were performed by using SPSS20.0 software. Measurement data, such as perioperative indicators and nutrition status were expressed as (x±s),, and were examined by independent test. Count data such as anal function and postoperative complications were examined by chi square test. Cumulative survival were examined by Log-Rank test. A P value <0.05 was considered as statistically significant difference. Results There was no significant difference in the amount of blood loss, operation time, number of harvested lymph nodes, defecation ability on 3 months and 12 months after operation, as well as incidence of complication and hospitalization stay between two groups(P>0.05). The postoperative recovery time of intestinal function in group A was shorter than that in group B(P<0.05). The excellent rate of defecation was significantly better than that in group B at 6 months after operation(χ~2=4.237, P=0.039). The hospitalization cost was significantly lower than that in group B(t= 8.290, P=0.000). Kaplan-Meier survival analysis showed that the cumulative survival of the two groups were 83.3% and 84.8%respectively(χ~2=0.002,P=0.969).Conclusion There were no significant difference in complications and survival rate of patients with low rectal cancer undergo laparoscopic modified Bacon’s radical operation of rectal cancer or double stapling technique anterior resection of rectum.However,the improvement of intestinal function recovery and elimination ability of the former after operation is more significantly,which deserves clinical attention.
作者
刘李
杨烈
杨柳
贺玉华
Liu Li;Yang Lie;Yang Liu;He Yuhua(Ziyang Hospital,West China Hospital,Sichuan University,Sichuan 641300,China;West China Hospital Sichuan University,Sichuan 610041,China)
出处
《中华普外科手术学杂志（电子版）》
2020年第1期46-49,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
四川省卫生和计划委员会2018年计划项目(18PJ247)~~
关键词
直肠肿瘤
腹腔镜
改良直肠癌根治术
Rectal neoplasms
Laparoscopes
Modified bacons radical operation of rectal cancer
