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腹腔镜下拉下式和双吻合器直肠超低位前切除术对直肠癌患者肛门功能及术后并发症的影响比较
作者:艾旭  龙舟  马旭  苏纯洁  陈莉杰 
单位:荆门市第一人民医院肛肠外科  湖北 荆门 448000 
关键词:直肠肿瘤/外科学 腹腔镜检查 肛管/外科学 吻合术 外科/方法 吻合术 外科/仪器和设备 手术后并发症 
DOI:10.13267/j.cnki.syzlzz.2019.01.009
出版年,卷(期):页码:2019,34(1):43-47
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摘要:

目的 探讨腹腔镜下双吻合器和拉下式直肠超低位前切除术对直肠癌患者肛门功能及术后并发症的影响。方法 选取110例超低位直肠癌患者以随机数字表法分为双吻合器直肠超低位前切除术组(55例)和拉下式直肠超低位前切除术组(55例),分别采用腹腔镜下双吻合器和拉下式直肠超低位前切除术治疗。比较两组患者术后随访肛门功能综合评分优良率、便意感正常率及术后并发症发生率。结果 拉下式直肠超低位前切除术组患者术后3个月和6个月肛门功能综合评分优良率以及便意感正常率均高于双吻合器直肠超低位前切除术组(均P<0.05);两组患者术后12个月肛门功能综合评分优良率和便意感正常率比较,差异均无统计学意义(均P>0.05)。两组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论 腹腔镜下拉下式直肠超低位前切除术治疗直肠癌患者可有效早期改善肛门功能,提高生活质量,且未增加术后并发症发生风险,价值优于腹腔镜下双吻合器直肠超低位前切除术。

Objective To investigate the influence of laparoscopic double stapler ultralow anterior resection and laparoscopic pull-down ultralow anterior resection on the anal function and postoperative complications of patients with rectal cancer. Methods A total of 110 patients with ultralow rectal cancer were enrolled and randomly assigned into the laparoscopic double stapler ultralow anterior resection group (55 patients) and the laparoscopic pull-down ultralow anterior resection group (55 patients). The rates of good anal function, normal meaning sense and postoperative complications were compared between the two groups during follow-up. Results Both the rates of good anal function and normal meaning sense were significant higher in the laparoscopic pull-down ultralow anterior resection group than those in the laparoscopic double stapler ultralow anterior resection group at 3 months and 6 months after operation (both P<0.05). Nevertheless, no significant difference was observed for the rate of good anal function or the rate of normal meaning sense at 12 months after operation between the two groups (both P>0.05). Finally, there was no significant difference in the postoperative complications incidence between the two groups (P>0.05). Conclusion Compared with minimally invasive double stapler, minimally invasive pull down for anterior resection can efficiently improve the anal function; increase the quality of life, without increasing the postoperative complication risk in the treatment of patients with ultralow rectal cancer.

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