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中华普外科手术学杂志(电子版) ›› 2022, Vol. 16 ›› Issue (01) : 52 -55. doi: 10.3877/cma.j.issn.1674-3946.2022.01.016

论著

双镜联合全直肠系膜切除术治疗低位直肠癌的近中期随访分析
王勇1, 靖艳1, 周华强2,()   
  1. 1. 054000 河北邢台,邢台市第五医院
    2. 050031 河北石家庄,河北医科大学第一附属医院
  • 收稿日期:2020-11-28 出版日期:2022-02-26
  • 通信作者: 周华强

Follow-up analysis of the treatment of low rectal cancer by dual-lens combined total mesenterectomy

Yong Wang1, Yan Jing1, Huaqiang Zhou2,()   

  1. 1. Xingtai Fifth Hospital, Xingtai Heibei Province 054005, China
    2. First Affiliated Hospital of Hebei Medical University, Shijiazhuang Heibei Province 050031, China
  • Received:2020-11-28 Published:2022-02-26
  • Corresponding author: Huaqiang Zhou
  • Supported by:
    Hebei Health and Family Planning Commission Project(20180233)
引用本文:

王勇, 靖艳, 周华强. 双镜联合全直肠系膜切除术治疗低位直肠癌的近中期随访分析[J/OL]. 中华普外科手术学杂志(电子版), 2022, 16(01): 52-55.

Yong Wang, Yan Jing, Huaqiang Zhou. Follow-up analysis of the treatment of low rectal cancer by dual-lens combined total mesenterectomy[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(01): 52-55.

目的

探讨双镜联合全直肠系膜切除术(La-TaTME)治疗低位直肠癌的近中期疗效。

方法

回顾性分析2017年2月至2018年3月两家医院收治的63例低位直肠癌患者病例资料,均接受TME治疗,将接受完全腹腔镜TME的30例患者纳入TME组,将接受La-TaTME治疗的33例患者纳入La-TaTME组。采用SPSS 24.0软件进行数据处理,围手术期相关指标、肿瘤学指标等计量资料以(

xˉ
±s)表示,采用独立样本t检验;并发症、复发率及转移率等计数资料采用χ2检验。P<0.05为差异有统计学意义。

结果

两组患者手术时间、术后排气时间、下床活动时间、胃肠功能恢复时间、肿块直径、标本长度、淋巴结清扫数量、肿块下缘距远切端距离、术后2年复发率及转移率相比,差异均无统计学意义(P>0.05)。La-TaTME组术中出血量、住院时间均比TME组低(P<0.05)。La-TaTME组并发症总发生率比TME组低(12.1% vs. 33.3%),差异有统计学意义(P<0.05)。

结论

La-TaTME治疗低位直肠癌可减少术中出血,加速恢复进程,并可降低并发症风险,但在降低近中期复发率、转移率方面优势不明显。

Objective

To explore the efficacy of double-lens combined total mesorectal excision(La-TaTME)in the treatment of low rectal cancer.

Method

The clinical data of 63 patients with low rectal cancer from February 2017 to March 2018 were analyzed retrospectively. All patients received TME,30 patients who received complete laparoscopic TME and 33 patients who received La-TaTME were divided into two groups. SPSS 24.0 software was used for data processing. Perioperative related indicators and oncological indicators were expressed as(

xˉ
±s)and t test was used. Count data such as complications,recurrence rate and metastasis rate were expressed by χ2 test,P<0.05 is considered statistically significant.

Result

There were no significant differences between the two groups in operation time,postoperative exhaust time,ambulation time,gastrointestinal function recovery time,mass diameter,specimen length,lymph node dissection number,distance between lower margin of mass and distal incision,recurrence rate and metastasis rate 2 years after surgery(P>0.05). The amount of intraoperative bleeding and length of hospital stay in La-TaTME group were lower than those in TME group(P<0.05). The total incidence of complications in the La-TaTME group was lower than that in the TME group(12.1% vs. 33.3%)and the difference was statistically significant(P<0.05).

Conclusion

La-TaTME for lower rectal cancer can reduce intraoperative bleeding,speed up the recovery process,and reduce the risk of complications,but it has no obvious advantages in reducing the recurrence rate and metastasis rate in the near to midterm.

表1 63例低位直肠癌患者不同术式两组患者一般资料比较[(
xˉ
±s),例]
表2 63例低位直肠癌不同术式两组患者围术期相关指标比较(
xˉ
±s
表3 63例低位直肠癌不同术式两组患者肿瘤学指标比较(
xˉ
±s
表4 63例低位直肠癌不同术式两组患者术后并发症发生情况比较[例(%)]
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