摘要
目的探讨3D腹腔镜经骶尾腹与经腹会阴入路行直肠癌根治术的效果。方法回顾性选取2017年1月至2020年1月山东大学齐鲁医院(青岛)收治的低位直肠癌患者86例为研究对象,按手术入路的不同分为对照组和观察组,每组43例。对照组采用3D腹腔镜经腹会阴入路直肠癌切除术,观察组采用3D腹腔镜经骶尾腹入路直肠癌根治术。比较两组围手术期指标以及术前、术后6个月糖类抗原(CA)242、CA724、癌胚抗原(CEA)水平,比较两组局部复发率以及存活率。结果观察组手术时间、术中出血量、排气时间、住院时间均少于对照组[(182.04±50.87)min比(210.59±61.03)min、(89.18±12.57)ml比(116.58±22.09)ml、(2.94±0.58)d比(4.56±1.07)d、(10.65±2.03)d比(14.06±2.84)d](P<0.05)。观察组排尿功能恢复较好,两组患者术后排尿功能分级比较差异有统计学意义(P<0.05)。观察组术后6个月血清CEA、CA242、CA274水平低于对照组[(4.13±0.46)μg/L比(5.01±0.72)μg/L、(14.01±5.16)kU/L比(16.97±5.76)kU/L、(4.19±0.68)kU/L比(4.97±0.87)kU/L](P<0.05)。观察组术后24个月存活率高于对照组[88.37%(38/43)比69.77%(30/43)](χ^(2)=4.50,P<0.05),复发率低于对照组[4.65%(2/43)比27.91%(12/43)](χ^(2)=8.53,P<0.05)。结论3D腹腔镜经骶尾腹入路直肠癌根治术可有效短缩手术时间,减少出血量,还可改善患者肛门功能,局部复发率较低,值得临床推广使用。
Objective To investigate the effect of 3D laparoscopic trans-sacrococcygeal and transabdominal perineal in the treatment of low rectal cancer.Methods The clinical data of 86 patients with low rectal cancer admitted to Qilu Hospital of Shandong University(Qingdao)from January 2017 to January 2020 were collected retrospectively,and they were divided into the control group and the observation group by the different surgical approaches,with 43 cases in each group.The control group was treated with 3D laparoscopic transabdominal perineal resection of rectal cancer,and the observation group was treated with 3D laparoscopic trans-sacrococcygeal resection of rectal cancer.Perioperative indexes in the two groups were recorded.The levels of carbohydrate antigen(CA)242,CA724,and carcinoembryonic antigen(CEA)were compared before and 6 months after the surgery.Follow-up was arranged to record the local recurrence rate and survival rate.Results The operative time,intraoperative blood loss,exhaust time,hospitalization time in the observation group were lower than those in the control group:(182.04±50.87)min vs.(210.59±61.03)min,(89.18±12.57)ml vs.(116.58±22.09)ml,(2.94±0.58)d vs.(4.56±1.07)d,(10.65±2.03)d vs.(14.06±2.84)d,the differences were statistically significant(P<0.05).The urination function of the observation group recovered well after the surgery,and there was statistical significance in the grading of urination function between the two groups(P<0.05).The levels of CEA,CA242 and CA274 in the observation group at 6 months after the surgery were lower than those in the control group:(4.13±0.46)μg/L vs.(5.01±0.72)μg/L,(14.01±5.16)kU/L vs.(16.97±5.76)kU/L,(4.19±0.68)kU/L vs.(4.97±0.87)kU/L,the differences were statistically significant(P<0.05).The survival rate in the observation group was higher than that in the control group:88.37%(38/43)vs.69.77%(30/43);and the recurrence rate was lower than that in the control group:4.65%(2/43)vs.27.91%(12/43),the differences were statistically significant(χ^(2)=4.50,8
作者
彭彬
陈绪安
Peng Bin;Chen Xu′an(Department of Medical Administration,Qilu Hospital of Shandong University(Qingdao),Qingdao 266035,China)
出处
《中国医师进修杂志》
2023年第6期557-561,共5页
Chinese Journal of Postgraduates of Medicine
关键词
直肠肿瘤
腹腔镜手术
肿瘤复发
局部
手术入路
Rectal neoplasms
Laparoscopy
Neoplasm recurrence,local
Surgical approache
