腹腔镜全直肠系膜切除术与经括约肌间切除术对低位直肠癌患者的近远期疗效比较

目的:比较腹腔镜全直肠系膜切除术(TME)与经括约肌间切除术(ISR)对低位直肠癌患者的近远期疗效。方法:选取72例低位直肠癌患者作为研究对象,按照随机数字表法将其分成对照组与观察组各36例。对照组行腹腔镜下ISR治疗,观察组行腹腔镜下TME治疗。比较两组手术相关指标水平、并发症发生率,术后1、5年生存率,以及术后5年肿瘤局部复发率。结果:观察组手术时间、住院时间短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05);两组术后并发症发生率、术后1年生存率比较,差异均无统计学意义(P>0.05);观察组术后5年生存率为83.33%,高于对照组的61.11%,肿瘤局部复发率为19.44%,低于对照组的41.67%,差异均有统计学意义(P<0.05)。结论:采用腹腔镜下TME治疗低位直肠癌患者的效果优于ISR,能够明显减少术中出血量,缩短手术时间,促进患者早日康复出院,对降低肿瘤局部复发率、延长生存期具有积极作用。

Comparison of short-term and long-term effects of laparoscopic total mesorectal excisionand intersphincteric resection in treatment of patients with low rectal cancer

Objective:To compare short-term and long-term effects of laparoscopic total mesorectal excision(TME)and intersphincteric resection(ISR)in treatment of patients with low rectal cancer.Methods:72 patients with low rectal cancer were selected as the research objects,and were divided into control group and observation group according to the random number table method,36 cases in each.The control group received laparoscopic ISR treatment,while the observation group received laparoscopic TME treatment.The surgical indicators,complications,1-year and 5-year survival rates after the surgery,and tumor recurrence rate 5 years after the surgery were compared between the two groups.Results:The operation time and hospital stay of the observation group were shorter than those of the control group;the intraoperative blood loss was less than that of the control group;and the differences were statistically significant(P<0.05).There were no significant differences in the incidence of postoperative complications and 1-year survival rate between the two groups(P>0.05).The 5-year survival rate(83.33%)of the observation group was higher than that of the control group(61.11%);the local tumor recurrence rate(19.44%)was lower than that of the control group(41.67%);and the differences were statistically significant(P<0.05).Conclusions:Laparoscopic TME is superior to ISR in the treatment of low rectal cancer.It can significantly reduce the intraoperative blood loss,shorten the operation time,promote the patients’early recovery and discharge,and has positive effects on reducing the tumor recurrence rate and prolonging the survival rate.