摘要
目的 探究4K腹腔镜辅助经肛全直肠系膜切除术(TaTME)治疗低位直肠癌的临床效果。方法 选取2019年7月至2021年1月于本院接受4K腹腔镜辅助TaTME治疗的52例低位直肠癌患者为观察组,另选取2018年1月至2019年6月接受腹腔镜辅助全直肠系膜切除术(LaTME)治疗的50例低位直肠癌患者为对照组。比较2组患者手术指标及术后3个月肛门功能恢复情况;比较2组患者的生存情况。结果 与对照组相比,观察组患者手术时间长、术中出血量多、切缘与肿瘤下缘距离短、手术费用少,差异均具有统计学意义(P<0.05)。术后3个月,观察组患者肛门功能恢复率为94.23%,明显高于对照组的80.00%,差异具有统计学意义(P<0.05)。2组患者随访20~47个月,平均(33.90±9.75)个月,其中观察组死亡6例(肿瘤相关死亡3例,心、肾功能疾病3例),对照组肿瘤相关死亡8例。Kaplan-Meier结果显示,2组患者的平均生存时间差异无统计学意义(P>0.05)。结论 4K腹腔镜辅助TaTME治疗低位直肠癌,可以提高患者的肛门功能恢复质量,减少手术费用,但更细致的手术操作会延长手术时间,增加术中出血量,需要结合患者具体情况制定治疗方案。
Objective To investigate the efficacy of 4K laparoscope assisted transanal total mesorectal excision(TaTME) in the treatment of low rectal cancer.Methods A total of 52 patients with low rectal cancer who were treated by 4K laparoscope assisted TaTME in our hospital from July 2019 to January 2021 were selected as the observation group.A total of 50 patients with low rectal cancer who underwent laparoscopic assisted total mesorectal excision(LaTME) from January 2018 to June 2019 were selected as the control group.The surgical indicators and anal function recovery 3 months after operation were compared between the two groups.The survival of the two groups were compared.Results Compared with the control group,the observation group had a longer operation time,more intraoperative bleeding,a shorter distance between the resection margin and the lower margin of the tumor,and less operation cost,with statistically significant differences(P<0.05).The recovery rate of anal function 3 months after operation in the observation group was 94.23%,which was significantly higher than 80.00% in the control group,and the difference was statistically significant(P<0.05).Patients in the two groups were followed up for 20 to 47 months,with an average of(33.90±9.75) months,including 6 deaths(3 tumor-related deaths,3 cardiac and renal diseases) in the observation group and 8 tumor-related deaths in the control group.Kaplan-Meier result showed that there was no statistical significance in the mean survival time between the two groups(P>0.05).Conclusion 4K laparoscope-assisted TaTME in the treatment of low rectal cancer can improve the quality of anal function recovery of patients,reduce the cost of surgery.However,more detailed surgical operations will prolong the operation time and increase the amount of intraoperative blood loss,therefore,the treatment plan should be formulated combined with the specific situation of patients.
作者
李璇
于和
王煦
李德辉
LI Xuan;YU He;WANG Xu;LI De-hui(Disinfection Supply Room,Qingdao Municipal Hospital,Qingdao Shandong 266000,China;Anesthesia and Operating Room,Qingdao Municipal Hospital,Qingdao Shandong 266000,China;Department of Colorectal Surgery,Qingdao Municipal Hospital,Qingdao Shandong 266000,China)
出处
《局解手术学杂志》
2023年第11期1013-1016,共4页
Journal of Regional Anatomy and Operative Surgery
