摘要
【目的】探讨腹腔镜下柱状经腹会阴切除术治疗低位直肠癌患者的近远期疗效。【方法】回顾性分析2009年2月至2014年2月徐州医科大学附属医院胃肠外科收治的80例低位直肠癌患者的临床资料，其中43例行腹腔镜下柱状经腹会阴切除术治疗（观察组），37例行腹会阴联合切除术治疗（对照组）。对比分析两组患者手术时间、术中出血量、术后肠道排气、引流管拔除及下床活动时间，并观察两组患者术后并发症发生情况，术后3个月、6个月、1年的肿瘤复发率及术后6个月、1年、3年的病死率。【结果】两组患者手术时间比较，差异无统计学意义（P〉0．05）；观察组术后肠道排气、引流管拔除及下床活动时间均明显短于对照组，观察组术中出血量明显少于对照组，差异均具有统计学意义（均P〈0．05）。观察组术后并发症发生率为6．98％（3／43）明显低于对照组的32．43％（12／37），差异具有统计学意义（x2=6．871，P=0．009〈0．05）。观察组术后3个月、6个月局部肿瘤复发率及术后6个月、1年的病死率与对照组比较，差异无统计学意义（P〉0．05）；但观察组术后1年的局部肿瘤复发率及术后3年的病死率均明显低于对照组，差异具有统计学意义（P〈0．05）。【结论】腹腔镜下柱状经腹会阴切除术治疗低位直肠癌患者可明显减少术后并发症发生率，降低肿瘤复发率及患者病死率。
[Objective]To investigate the short and long term efficacy of laparoscopic cylindrical abdominoperineal re- sectioa far treatment of the low rectal cancer. [Methodsl The clinical data of 80 patients with lower rectal cancer treated in the Department of Gastrointestinal Surgery of Affiliated Hospital of Xuzhou Medical University from February 2009 to February 2014 were analyzed retrospectively. Among them, 43 patients treated with laparoscopic cylindrical abdominoper- ineal resection were recorded as group A, and 37 patients treated with abdominal perineal resection were recorded as group B. The operation times, intraoperative blood loss, and postoperative intestinal exhaust, drainage tube removal and ambu- lation times were compared and analyzed between the two groups. The complications and the recurrence rate of the tumors after 3 months, 6 months and 1 years of operation and the mortality rates after 6 months, 1 year and 3 years of operation of the two groups were observed. [Results] The operation times of group A and group B had no significantly different （ P 〉0.05）, but the postoperative intestinal exhaust, drainage tube removal and ambulation times in the A group were signif- icantly shorter than those in the B group （ P 〈0.05）. The intraoperative blood loss of the A group was significantly less than that of the B group （ P 〈0.05）. The total complication incidence rate of the A group was 6.98% （3/43）, which was significantly lower than that of 32.43 % （12/37） of the g group （ P 〈0.05）. There were no significant differences in the rates of local tumor recurrence at 3 and 6 months after operation between the two groups （ P 〉0.05） ,or between the mortality rate after 6 months and 1 year after operation （ P ;〉0.05）. However, he local tumor recurrence rate after 1 year of operation and mortality rate after 3 years of operation in the A group were significantly lower than those in the B group （ P 〈0.05）. [Conclusion]Laparoscopic cylindrical abdominoperineal resecti
出处
《医学临床研究》
CAS
2018年第2期242-245,共4页
Journal of Clinical Research
