摘要
目的比较腹腔镜辅助经肛门全直肠系膜切除(TaTME)术与超低温冷冻治疗T_(2-3)N_(0)M_(0)期直肠癌患者的疗效。方法回顾性分析2017年5月至2018年3月收治的63例T_(2-3)N_(0)M_(0)期直肠癌患者的临床资料,根据不同治疗方式分为TaTME术组(n=33例)和超低温组(n=30例),TaTME术组:行腹腔镜辅助TaTME术治疗;超低温组:行超低温冷冻治疗。采用SPSS 23.0软件处理数据,肛门失禁Wexner评分、性生活质量问卷(PISQ)评分以(x±s)表示,独立样本t检验;并发症发生率、排尿功能、治愈率、复发率用[n(%)]表示,行χ^(2)检验。P<0.05为差异有统计学意义。结果两组患者术后1年、3年Wexner评分,排尿功能Ⅱ级、Ⅲ级、Ⅳ级占比,直肠癌治愈率及复发率比较,差异均无统计学意义(P>0.05);超低温组患者术后1年及3年PISQ评分比TaTME术组高,排尿功能Ⅰ级占比较TaTME术组高(P<0.05);超低温组患者并发症发生率比TaTME术组低(P<0.05)。结论腹腔镜辅助TaTME术与超低温冷冻技术治疗T_(2-3)N_(0)M_(0)期直肠癌患者均可保留肛门,治愈率均较高,腹腔镜辅助TaTME术可行淋巴结清扫,超低温冷冻治疗可保护患者性功能和排尿功能,且术后并发症发生率更低。
Objective To compare the efficacy of laparnscopie ssted transanal tolal mesorectal excision(TaTME)and crthera in T_(2-3)N_(0)M_(0) rectal cancer patients.Methods The clinical data of 63 patients with T_(2-3)N_(0)M_(0) rectal cancer from May 2017 to March 2018 were retrospectively analyzed.Acording to dfferent treatment methods,the patients were divided into TaTME goup(n=33 cases)and hypothermia group(n=30 cases).TaTME goup:treated with laparoscopic TaTME ureatment;Hyperthermnia goup:treated with underg cryotherapy.SPSS 23.0 software was used to pocess the data.Wexner score of anal incontinence and Pelvic Ogan Prolapse/Urinary Incontinence Sexual Questionnaire(PISQ)score were expressed in(x±s)and independent t test;the incidence of comnplicaions,micturition function,cure rate and recurence rale were expressed by[n(%)],and χ^(2) test were perfomed.P<0.05 was satistically significant.Results There was no satistical significant diference betveen the two groups in Wexner score.urinary function grade Ⅱ、Ⅲ and Ⅳ,cure nate and rcurrence rate of rectal cancer al 1 and 3 years afer operation(P>0.05);the PISQ scores of patients in the ulralow temperature group were higher than those in the TaTME goup al I and 3 years after openation,and the proportion of grade Ⅰ mieturition function was higher than that in the TaTME group(P<0.05);the incidence of complications in the hypothernia group was lower than that in the TaTME group(P<0.05).Conclusion Both laparosopic asted TaTME and cryotherapy can preserve the anus in patients with T_(2-3)N_(0)M_(0) stage rectal cancer,with a high cure rate.Laparoscopic assistod TaTME is feasible for lymph node iscction,and cryotherapy can prtect the sexual function and micturition function of patients with lower complications.
作者
吉祖进
雷新益
张志云
蒋学军
杨勇
庹磊
严明宇
Ji Zujin;Lei Xinyi;Zhang Zhigrun;Jliang Xuejun;Yang Yong;Chi Lei;Yan Mingyu(Department of Colorectal and Anal Surgery,Dongfeng General Hospital of Chinese Medicine,Shiyan Hubei Province 442008,China;Tianmen First People's Hospital,Tianmen Hubei Province 431700,China)
出处
《中华普外科手术学杂志（电子版）》
2022年第4期439-442,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
湖北省卫生健康委员会项目(WJ2019H212)。
