腹腔镜下经肛门拖出式前切术对低位直肠癌患者并发症及复发率的影响

目的分析腹腔镜下经肛门拖出式前切术对低位直肠癌患者并发症及复发率的影响，为临床治疗提供参考。 方法回顾性分析2014年4月至2017年10月期间接受腹腔镜下经肛门拖出式前切术治疗的低位直肠癌患者(观察组，n＝80)临床资料，同期腹腔镜下非肛门拖出式前切术治疗的低位直肠癌患者为对照组(对照组，n＝80)。数据统计采用SPSS21.0统计软件完成，术中术后计量资料用平均数±标准差表示，两组比较采用独立t检验；术后并发症和复发率比较采用χ²检验。P<0.05为差异具有统计学意义。 结果与对照组相比，观察组病理切缘距离明显增大[对照组(3.0±0.6) cm,观察组(3.9±1.1) cm, P<0.05]、局部复发率明显降低[对照组5.0% ,观察组1.3%, P<0.05]，而并发症发生率、手术时间、术中出血量、淋巴结清扫数和阳性淋巴结数目之间差异无统计学意义(P>0.05)。 结论腹腔镜下经肛门拖出式前切术治疗低位直肠癌简便易行，复发率低。

Clinical observation of laparoscopic transanal pull through anterior resection in treating low rectal cancer

ObjectiveTo observe complications and recurrence of patients with low rectal cancer who underwent laparoscopic transanal pull through anterior resection. MethodsFrom April 2014 to October 2017, clinical data of 80 patients (observation group) with low rectal cancer underwent laparoscopic transanal pull through anterior resection, were analyzed retrospectively. While 80 patients (control group) with low rectal cancer underwent conventional laparoscopic anterior resection. Statistical analysis were performed by using SPSS21.0 software. Postoperative measurement data were expressed as mean±standard deviation, and were examined by independent t-test. The postoperative complications and recurrence rate were expressed as percentage (%), and was examined by chi-square test. A P value<0.05 was considered as significant difference. ResultsCompared with control group, pathological margin distance increased significantly in observation group [(3.0±0.6) cm vs. (3.9±1.1) cm, P<0.05]. However, the local recurrence rate was significantly lower in observation group (5.0% vs. 1.3%, P<0.05). There were no significant difference between two groups in terms of incidence rate, operation time, intraoperative bleeding, lymph nodes and the number of positive lymph nodes (P>0.05). ConclusionLaparoscopic transanal pull through anterior resection for low rectal cancer is safe and feasible, with lower recurrence rate.