腹腔镜辅助经肛直肠全系膜切除术治疗超低位直肠癌的疗效及安全性分析

目的通过与腹腔镜直肠全系膜切除术（La-TME）比较，分析腹腔镜辅助经肛直肠全系膜切除术（La-TaTME）用于治疗超低位直肠癌的临床疗效及安全性。 方法选取2015年8月至2018年3月成都市温江区人民医院收治的114例超低位直肠癌患者，随机数字表法分为观察组与对照组，各57例，分别进行La-TaTME和La-TME治疗。比较两组患者临床指标、便秘患者生活质量量表（PAC-QOL）评分、排尿功能、并发症及预后情况。 结果与对照组比较，观察组手术时间更长，肛门排气时间、住院时间更短，差异均有统计学意义（P<0.05）。术后12个月时，两组患者PAC-QOL评分均显著增高，且观察组高于同期对照组（P<0.05）。两组患者术后排尿功能、并发症发生率以及1年生存率、远处转移率和局部复发率差异均无统计学意义。 结论La-TaTME治疗超低位直肠癌的手术时间较La-TME有所延长，但更有利于患者早期康复和生活质量的提高。

Laparoscopic assisted transanal total mesorectal excision in the treatment of ultra-low rectal cancer

ObjectiveBy comparing with laparoscopic total mesorectal excision (La-TME), to analyze the clinical efficacy and safety of laparoscopic transanal total mesorectal excision (La-TaTME) in the treatment of ultra-low rectal cancer. MethodsFrom August 2015 to March 2018, 114 patients with ultra-low rectal cancer admitted to Wenjiang District People’s Hospital of Chengdu were randomly divided into La-TaTME group and La-TME group, each with 57 cases. The clinical indexes, PAC-QOL score, micturition function, complications and prognosis between the two groups were compared. ResultsCompared with La-TME group, the operation time of La-TaTME group was longer, the anal exhaust time and hospitalization time were shorter, the differences were statistically significant (P< 0.05). At 12 months after operation, PAC-QOL scores of the two groups were significantly raised, and La-TaTME group was higher than La-TME group (P<0.05). There were no significant differences between the two groups in urination function, complication rate, 1-year survival rate, distant metastasis rate or local recurrence rate. ConclusionThe operation time of La-TaTME is longer than that of La-TME in the treatment of ultra-low rectal cancer, La-TaTME is more conducive to the early rehabilitation and quality of life of patients.