摘要
目的评价经肛拖出式腹腔镜直肠癌前切除术治疗中低位直肠癌的手术方法和疗效。方法 2015年4月至2017年4月,前瞻性选择武汉市普仁江岸医院收治的中低位直肠癌患者100例,按照随机数表法将患者分为对照组和观察组,各50例,分别进行腹腔镜下直肠癌前切除术与经肛拖出式全腹腔镜直肠癌前切除术治疗,对比两组患者的围手术期情况、炎性因子肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平以及随访情况。结果 (1)观察组的手术时间、肠功能恢复时间、引流量、住院时间与治疗费用均显著少于对照组,差异有统计学意义(P<0.01)。(2)两组患者术前TNF-α、IL-6水平差异无统计学意义。与术前相比,两组患者术后的TNF-α、IL-6水平均显著降低(P<0.05),且观察组术后的TNF-α、IL-6水平显著低于对照组同期,差异有统计学意义(P<0.05)。(3)两组并发症总发生率、1年复发率和病死率比较,差异均无统计学意义(χ~2=0.154、0.519、0.852,均P>0.05)。结论经肛拖出式全腹腔镜直肠前切除术治疗中低位直肠癌效果理想,可显著改善手术相关指标,减少机体炎性反应,值得推行。
Objective：To evaluate the efficacy of transanal pull-through laparoscopic anterior resection in the treatment of middle and low rectal cancer. Methods：From April 2015 to April 2017, one hundred cases with middle and low rectal cancer admitted to the Hospital of PuRen River in Wuhan were prospectively selected. According to the random number table method, the patients were divided into the control group （treated with laparoscopic anterior resection） and the observation group （treated with transanal pull-through resection and anastomosis）, with 50 cases in each group. The perioperative period, levels of inflammatory factors such as tumor necrosis factor alpha （TNF-α）, interleukin 6 （IL-6） and follow-up data were compared between the two groups. Results：（1） The operation time, recovery time of intestinal function, flow rate, hospital stay, costs of the observation group were significantly less than those of the control group, and the differences were statistically significant （P〈0.01）. （2） There were no significant differences in the levels of TNF-α and IL-6 between the two groups before operation. Compared with preoperation, the levels of TNF-α and IL-6 in the two groups decreased significantly （P〈0.05）, and the level in the observation group was significantly lower than the control group at the same period （P〈0.05）. （3） There were no significant differences in the incidence of complications, 1 year recurrence rate and fatality rate between the two groups （χ2=0.154, 0.519, 0.852; all P〉0.05）. Conclusion：Transanal pull-through total laparoscopic anterior resection is an ideal treatment for middle and low rectal cancer, which can significantly improve operation related indicators, reduce the inflammatory response to the body, and is of worth carrying out.
作者
尹兴锋
江帆
Yin Xingfeng;Jiang Fan(Department of Surgery,the Hospital of PuRen River in Wuhan,Wuhan 430012,China;Department of Hepatobiliary Surgery,Wuhan Puren Hospital,Wuhan 430081,China)
出处
《中华普通外科学文献（电子版）》
2018年第6期409-412,共4页
Chinese Archives of General Surgery(Electronic Edition)
基金
武汉市卫生和计划生育委员会科研项目(WX18D37)
