[1]叶 博,陈 焱.腹腔镜全直肠系膜切除术对中低位直肠癌患者治疗效果及术后并发症的影响[J].医学信息,2023,36(20):117-120.[doi:10.3969/j.issn.1006-1959.2023.20.022]
　YE Bo,CHEN Yan.Effect of Laparoscopic Total Mesorectal Excision on the Treatment Effect and Postoperative Complications of Patients with Middle and Low Rectal Cancer[J].Journal of Medical Information,2023,36(20):117-120.[doi:10.3969/j.issn.1006-1959.2023.20.022]
点击复制

腹腔镜全直肠系膜切除术对中低位直肠癌患者治疗效果及术后并发症的影响()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年20期
页码:
117-120
栏目:
论著
出版日期:
2023-10-15

文章信息/Info

Title:
Effect of Laparoscopic Total Mesorectal Excision on the Treatment Effect and Postoperative Complications of Patients with Middle and Low Rectal Cancer
文章编号:
1006-1959（2023）20-0117-04
作者:
叶 博; 陈 焱
（1.北京信息科技大学医院外科，北京 102206；2.北京京西肿瘤医院肿瘤外科，北京 100016）
Author(s):
YE Bo; CHEN Yan
(1.Department of Surgery,Beijing Information Science & Technology University School Hospital,Beijing 102206,China;2.Department of Oncology,Beijing Jingxi Tumor Hospital,Beijing 100016,China)
关键词:
腹腔镜全直肠系膜切除术; 中低位直肠癌; 肛门功能
Keywords:
Laparoscopy total mesorectal excision; Middle and low rectal cancer; Anal function
分类号:
R735.3+7
DOI:
10.3969/j.issn.1006-1959.2023.20.022
文献标志码:
A
摘要:
目的 研究腹腔镜全直肠系膜切除术对中低位直肠癌患者治疗效果及术后并发症的影响。方法 选取2016年1月-2020年11月北京京西肿瘤医院诊治的280例中低位直肠癌患者为研究对象，采用随机数字表法分为对照组（n=140）和观察组（n=140）。对照组采用传统开腹根治术，观察组采用腹腔镜全直肠系膜切除术，比较两组临床手术指标、肛门功能指标[肛管静息压（ARP）、肛管最大收缩压（AMSP）、直肠最大耐受量（RMTV）]、肛门功能评分（Wexner）、并发症发生率、2年生存率、局部复发率以及远处转移率。结果 观察组手术时间、术中出血量、术后肛门排气时间、术后进食时间以及住院时间均短于对照组（P＜0.05）；观察组ARP、AMSP小于对照组，RMTV大于对照组（P＜0.05）；观察组Wexner评分低于对照组（P＜0.05）；观察组并发症总发生率为10.71%，低于对照组的22.86%（P＜0.05）；随访2年，观察组生存率与对照组比较，差异无统计学意义（P＞0.05），但观察组局部复发率、远处转移率均低于对照组（P＜0.05）。结论 腹腔镜全直肠系膜切除术治疗中低位直肠癌可减少手术时间、术中出血量，缩短术后肛门排气、进食时间以及住院时间、降低术后并发症，保护肛门功能，改善患者远期预后，具有相对较理想的应用效果。
Abstract:
Objective To study the effect of laparoscopic total mesorectal excision on the treatment effect and postoperative complications of patients with middle and low rectal cancer.Methods A total of 280 patients with middle and low rectal cancer diagnosed and treated in Beijing Jingxi Tumor Hospital from January 2016 to November 2020 were selected as the research objects, and they were divided into control group (n=140) and observation group (n=140) by random number table method. The control group was treated with traditional open radical resection, and the observation group was treated with laparoscopic total mesorectal excision. The clinical operation indexes, anal function indexes[anal resting pressure (ARP), anal maximum systolic pressure (AMSP), rectal maximum tolerated dose (RMTV)], anal function score (Wexner), complication rate, 2-year survival rate, local recurrence rate and distant metastasis rate were compared between the two groups.Results The operation time, intraoperative blood loss, postoperative anal exhaust time, postoperative feeding time and hospitalization time of the observation group were shorter than those of the control group (P<0.05). ARP and AMSP in the observation group were smaller than those in the control group, and RMTV was larger than that in the control group (P<0.05). The Wexner score of the observation group was lower than that of the control group (P<0.05). The total incidence of complications in the observation group was 10.71%, which was lower than 22.86% in the control group (P<0.05). After 2 years of follow-up, there was no significant difference in the survival rate between the observation group and the control group (P>0.05), but the local recurrence rate and distant metastasis rate in the observation group were lower than those in the control group (P<0.05).Conclusion Laparoscopic total mesorectal excision in the treatment of middle and low rectal cancer can reduce the operation time, intraoperative blood loss, postoperative anal exhaust, eating time and hospitalization time, reduce postoperative complications, protect anal function, and improve the long-term prognosis of patients. It has a relatively ideal application effect.

参考文献/References:

[1]姚宏伟,张忠涛.腹腔镜直肠癌经肛门全直肠系膜切除技巧及疗效评价[J].中华普外科手术学杂志(电子版),2018,12(1):12-14.[2]张志鹏,姚宏伟,陈宁,等.腹腔镜辅助经肛门全直肠系膜切除术治疗中低位直肠癌的临床疗效[J].中华消化外科杂志,2017,16(7):695-700.[3]Arroyave MC,DeLacy FB,Lacy AM.Transanal total mesorectal excision (TaTME) for rectal cancer: Step by step description of the surgical technique for a two-teams approach[J].Eur J Surg Oncol,2017,43(2):502-505.[4]蔡栋臣,徐栋,柳旦.腹腔镜与开腹全直肠系膜切除术治疗中低位直肠癌的对比研究[J].腹腔镜外科杂志,2016,21(10):750-754.[5]徐栋,郭盖章,许力.腹腔镜与开腹结直肠癌完整系膜切除术的短期随访研究[J].解放军医药杂志,2016,28(9):44-46,58.[6]中华人民共和国卫生和计划生育委员会医政医管局,中华学会肿瘤学分会.中国结直肠癌诊疗规范(2017版)[J].中华外科杂志,2018,56(4):241-258.[7]Bernardi MP,Bloemendaal AL,Albert M,et al.Transanal total mesorectal excision: dissection tips using ’O’s and ’triangles’[J].Tech Coloproctol,2016,20(11):775-778.[8]徐勇超,王刚成,张占东,等．腹腔镜与开腹超低位直肠癌全直肠系膜切除术临床疗效的对比研究[J].中华胃肠外科杂志,2016,19(8):942-943．[9]韩寅,何勇,黄进.腹腔镜全直肠系膜切除术治疗老年中低位直肠癌的近期疗效及安全性评价[J].海南医学,2017,28(5):749-751.[10]邓小强,王利娜,孙胜,等.选择性侧方淋巴结清扫在腹腔镜低位进展期直肠癌全直肠系膜切除术中的应用[J].中国临床研究,2017,30(6):807-809.[11]Wexner SD,White CM.Improving rectal cancer outcomes with the national accreditation program for rectal cancer[J].Clin Colon RectalSurg,2020,33(5):318-324.[12]张峻岭,吴涛,陈国卫,等.局部复发直肠癌手术根治性和预后的影响因素分析[J].中华胃肠外科杂志,2020,23(5):472-479.[13]李由,冷蔚,吴红,等.腹腔镜辅助经肛门全直肠系膜切除术治疗中低位直肠癌的临床研究[J].腹腔镜外科杂志,2020,25(1):54-58.[14]李腾腾,刘浩,王凯,等.腹腔镜辅助经肛全直肠系膜切除术治疗低位直肠癌[J].山东医药,2019,59(12):56-58.[15]曹正涛,王西墨,张林.老年中低位直肠癌患者手助腹腔镜与开腹直肠癌根治术的疗效比较[J].中国老年学杂志,2016,36(20):5043-5045.[16]Uematsu D,Akiyama G,Sugihara T,et al.Transanal total pelvic exenteration： pushing the limits of transanal total mesorectal excision with transanal pelvic exenteration[J].Dis Colon Rectum,2017,60(6):647.[17]陈伟平,李其肯,范永田,等.中低位直肠癌腹腔镜与开放全系膜切除合并侧方淋巴结清扫围手术期临床分析[J].肿瘤防治研究,2017,44(6):418-422.[18]袁敏哲,姚长康,刘荣.腹腔镜与开腹手术治疗直肠癌对术后肛门功能、胃肠功能与血清胃肠激素的影响[J].结直肠肛门外科,2016,22(4):365-368.[19]方复,卢国春,毛华辉.腹腔镜全系膜切除术联合经肛门内括约肌切除术治疗超低位直肠癌的疗效分析[J].中华全科医学,2017,15(4):724-726.[20]管傲然,赵维山,李逊,等.直肠癌行腹腔镜辅助直肠癌前切除术术后吻合口瘘的相关因素分析[J].云南医药,2017,38(1):21-23.

相似文献/References:

[1]李 霜,贾梦滢,尤朝香,等.基于CiteSpace的中低位直肠癌保肛术后盆底肌功能研究热点的可视化分析[J].医学信息,2022,35(22):40.[doi:10.3969/j.issn.1006-1959.2022.22.007]
　LI Shuang,JIA Meng-ying,YOU Chao-xiang,et al.Visualization Analysis of Research Hotspots of Pelvic Floor Muscle Function After Anus-preserving Surgery for Middle and Low Rectal Cancer Based on CiteSpace[J].Journal of Medical Information,2022,35(20):40.[doi:10.3969/j.issn.1006-1959.2022.22.007]
[2]赖海平,蔡联明,刘振华,等.保留左结肠动脉腹腔镜全直肠系膜切除术治疗中低位直肠癌的疗效及对肛门功能的影响[J].医学信息,2022,35(15):117.[doi:10.3969/j.issn.1006-1959.2022.15.027]
　LAI Hai-ping,CAI Lian-ming,LIU Zhen-hua,et al.Effect of Laparoscopic Total Mesorectal Excision with Left Colonic Artery Preservation for Middle and Low Rectal Cancer and its Effect on Anal Function[J].Journal of Medical Information,2022,35(20):117.[doi:10.3969/j.issn.1006-1959.2022.15.027]

更新日期/Last Update: 1900-01-01