全直肠系膜切除治疗直肠癌的临床疗效观察

目的观察全直肠系膜切除治疗直肠癌的临床疗效和术后并发症的发生率。方法将2010年1月～2012年1月收治的80例直肠癌患者随机分为观察组与对照组各40例。对照组患者行传统直肠癌根治术,观察组患者行全直肠系膜切除术治疗。统计两组患者的手术时间、术中出血量、胃肠功能恢复时间及术后并发症的发生率。同时追踪随访两组患者的局部复发率和3年内的生存率。结果观察组患者的平均手术时间、胃肠功能恢复时间均短于对照组（P〈0.05）,术中出血量少于对照组（P〈0.05）。观察组患者术后吻合口出血、吻合口瘘、吻合口狭窄及肠梗阻并发症的总发生率为7.5%,对照组为17.5%,两组比较,差异具有统计学意义（P〈0.05）。观察组患者局部复发率及3年内的生存率依次为12.5%、65%;对照组依次为27.5%、45%。两组比较,差异具有统计学意义（P〈0.05）。结论与传统直肠癌根治术相比,全直肠系膜切除术治疗直肠癌的手术时间短、出血量少,恢复快,且并发症少,局部复发率低,能大大提高患者的生存率。

Analysis of clinical efficacy of total mesorectal excision for rectal cancer

Objective To analyze the clinical effect of total mesorectal excision for rectal cancer.Methods 80 patients with rectal cancer were divided into the observation group（40 cases）and the control group（40 cases）.The control group was treated with radical resection.The observation group was treated with total mesorectal excision.The amount of bleeding,gastrointestinal function recovery time,operation time of observation,incidence of postoperative complications,the local recurrence rate and 3 years survival rate were observed.Results The operation time,recovery time of gastrointestinal function of observation group were shorter than that of control group（P〈0.05）.The bleeding of observation group was less than that of control group（P〈0.05）.The postoperative anastomotic bleeding,anastomotic leakage,stenosis,obstruction and complication rate of observation group were significant diffident from that of the control group（P〈0.05）.The local recurrence and 5year survival rates of observation group and the control groups were12.5%,65% and 27.5%,45%（P〈0.05）.Conclusion Compared with traditional radical resection,total mesorectal excision for rectal cancer demonstrates advantages on operation time,bleeding,recovery,complications and survival rate.