直肠癌腹腔镜超低位前切除术后的肛门动力学与肛门功能的相关性研究

目的 探讨腹腔镜下直肠癌超低位前切除术后的肛门动力学变化以及肛门功能恢复情况的相关性.方法 选取确诊为直肠癌患者124例,随机分为腹腔镜超低位前手术切除组和开腹手术组.并于术后1个月、3个月、6个月随诊并评定患者的肛门动力学以及肛门功能的情况.结果 腹腔镜组和开腹组相比,腹腔镜组的住院时间(11.3±3.7)d、术中出血量(116.3±66.5)mL、手术时间(170.5±57.7)min以及术后肠道功能恢复时间(2.5±1.0)d上明显优于开腹组,差异具有统计学意义(P<0.05);但是两组在术中淋巴结清扫上无明显差异,不具统计学意义(P>0.05).腹腔镜组术后3个月和6个月的肛门最大收缩压、最大静息压、静息向量容积以及收缩向量容积明显优于开腹手术组,差异具有统计学意义(P<0.05).腹腔镜组和开腹手术组在术后1个月和6个月肛门功能方面比较发现,腹腔镜手术组的排便感觉、肛门控制力、排便时间以及便意感方面优于开腹手术组,差异具有统计学意义(P<0.05),但两组在术后6个月的排便次数方面比较,无统计学意义(P>0.05).结论 直肠癌患者腹腔镜下超低位前切除术后的肛门动力学及肛门功能的恢复情况,明显优于传统开腹手术组,效果好,值得医院推广使用.

Study of the Correlation between Anorectal Dynamics and Anorectal Function of Rectal Cancer after the Laparoscopic Ultra Low Anterior Resection

Objective To investigate the correlation between the changes of anal dynamics and the recovery of anal func -tion of rectal cancer after laparoscopic ultra low anterior resection .Methods 124 patients with rectal cancer were randomly di-vided into laparoscopic operation group and open operation group .The patients were followed up ,and the anal dynamics and anal function 1,3,and 6 months after surgery were evaluated .Results Compared with laparotomy group ,length of hospital stay (11.3 ±3.7)d,intraoperative bleeding(116.3 ±66.5)mL,operation time(170.5 ±57.7)min and postoperative intestinal function re-covery time(2.5 ±1)d of laparoscopic group were superior to the laparotomy group ,the difference was statistically significant (P<0.05);but there was no significant difference between the 2 groups in lymph node dissection (P>0.05).The maximum con-traction pressure of the anus ,maximum resting pressure ,resting vector volume and contraction vector volume of the laparoscopic group were significantly better than those of the open operation group 3 and 6 months after operation ,the difference was statistical-ly significant(P<0.05).The anal function of the 2 groups 1 and 6 months after surgery were compared,anal function of defeca-tion,anal control feeling ,defecation time and the sense of defecation of the laparoscopic group were better than those of the open operation group,the difference was statistically significant (P<0.05),but the two groups had no difference in defecation frequen-cy 6 months after operation(P>0.05).Conclusion The recovery of the anal dynamics and anal function of patients rectal canc-er treated with laparoscopic ultra low anterior resection is significantly better than the patients treated with traditional open opera -tion,the effect is ideal ,and it is worthy of promotion in hospital .