腹腔镜辅助TaTME术在低位直肠癌患者中的临床效果及安全性研究

目的分析腹腔镜辅助肛门全直肠系膜切除术(TaTME)术在低位直肠癌患者中的应用效果及安全性。 方法回顾性分析2013年1月至2017年8月64例低位直肠癌患者临床资料。按照术式不同分为TaTME组和ISR组，TaTME组患者行腹腔镜辅助TaTME术治疗，ISR组患者行腹腔镜辅助括约肌间切除(ISR)术治疗。采用SPSS20.0统计软件分析，并发症情况等计数资料组间比较采用χ²检验；术中术后指标和肛门失禁评分等计量资料采用( ±s)描述，独立样本t检验；生存率采用Kaplan－Meier法计算，组间行log－rank检验。P<0.05差异具有统计学意义。 结果TaTME组患者在初次下床时间、住院时间方面显著低于ISR组(P<0.05)；两组患者并发症比较差异无统计学意义(χ²＝2.98, P＝0.13)；TaTME组患者术后1、3个月Wexner评分显著低于ISR组(P<0.05)；TaTME组1年生存率、无病生存率与ISR组无差异(Log－Rank χ²＝0.54、1.32, P均>0.05)。 结论腹腔镜辅助TaTME术在低位直肠癌患者中效果显著，患者恢复快，安全性较高。

Clinical outcome and safety analysis of laparoscopic assisted TaTME for patients with low rectal cancer

ObjectiveTo analyze the efficacy and safety of laparoscopic assisted TaTME for patients with low rectal cancer. MethodsClinical data of 64 patients with low rectal cancer from January 2013 to August 2017 were retrospectively analyzed. The patients in TaTME group were treated with Laparoscopic assisted TaTME and those in ISR group were treated with Laparoscopic assisted sphincterotomy (ISR). The complications were analyzed by using SPSS20.0 software and compared by using χ² test. The intraoperative and postoperative indexes and anus incontinence score were expressed as mean+ standard deviation, and the independent sample t-test was employed. The survival rate was calculated by Kaplan-Meier method and log-rank test was performed among the groups. P<0.05 was considered as significant difference. ResultsTime of ambulation and hospital stay in TaTME group were significantly lower than those in ISR group (P<0.05). There was no significant difference of complications between two groups (χ²=2.98, P=0.13). The Wexner score in TaTME group was significantly lower than that in ISR group 1 and 3 months after operation (P<0.05). The 1-year survival rate and disease-free survival rate in TaTME group were not significantly different from those in ISR group (Log-Rank χ²=0.54, 1.32, P>0.05). ConclusionLaparoscopically assisted TaTME is effective for patients with low rectal cancer, with rapid recovery and high safety.