Miles术与Dixon术在低位直肠癌患者围术期指标及疗效比较

目的对比分析采用经腹会阴联合直肠癌切除术(Miles术)与经腹前切除术(Dixon术)治疗低位直肠癌的围术期指标及疗效。方法选择低位直肠癌患者60例,对其临床资料进行回顾性分析。按照手术方式分为Miles术组(29例)和Dixon术组(31例)。Miles术组采用经腹会阴联合直肠癌切除术,Dixon术组采用经腹前切除术,2组均接受3年随访。对比2组手术时间、术中失血量、肛门排气时间、住院时间、淋巴结清除数量、环周切缘阳性率、术后1年生存质量评分(PAC-QOL)、排尿功能、男性患者性功能及并发症情况,并比较2组3年无瘤生存期、总生存期、局部复发率、远处转移率。结果Dixon术组的手术时间、术中失血量、肛门排气时间、住院时间均少于Miles术组(P<0.05),PAC-QOL评分低于Miles术组(P<0.05),排尿功能、男性患者勃起功能及射精功能优于Miles术组(P<0.05)。结论Dixon术治疗低位直肠癌与Miles术相比,可明显缩短手术时间、肛门排气时间、住院时间,减少术中出血量,并可改善术后患者生活质量、排尿功能及男性患者的性功能。

Comparison of Perioperative Indexes and Efficacy between Miles and Dixon in Patients with Low Rectal Cancer

Objective To compare and analyze the perioperative indexes and efficacy of abdominoperineal resection(Miles)and transabdominal anterior resection(Dixon)for low rectal cancer.Methods 60 cases of patients with low rectal cancer were selected,and their clinical data were retrospectively analyzed.The patients were divided into Miles group(29 cases)and Dixon group(31 cases)according to operation methods.Miles group was treated with abdominoperineal resection,and Dixon group was treated with transabdominal anterior resection,and the two groups were followed for 3 years.The operative time,intraoperative blood loss,anal exhaust time,hospital stay,lymph node clearance quantity,positive rate of circumferential resection margin,quality of life score(PAC-QOL)1 year after operation,urinary function,sexual function of male patients and complications were compared between the 2 groups,and the 3-year disease-free survival,overall survival,local recurrence rate and distant metastasis rate were compared between the 2 groups.Results The operative time,intraoperative blood loss,anal exhaust time and hospital stay in Dixon group were lower than those of Miles group(P<0.05),and the PAC-QOL score was lower than that of Miles group(P<0.05).The urinary function and erectile function and ejaculation function of male patients were better than those of Miles group(P<0.05).Conclusion Compared with Miles,Dixon for low rectal cancer can significantly shorten the operative time,anal exhaust time and hospital stay,reduce the intraoperative blood loss,and improve the quality of life,urinary function and sexual function of male patients after operation.