传统术式与全直肠系膜切除术在直肠癌术后对局部复发排尿功能和性功能影响的比较

目的 比较分析传统术式和全直肠系膜切除术(TME)治疗直肠癌的临床疗效,并对术后局部复发、排尿功能和性功能的影响性进行对比,为直肠癌临床治疗方案提供依据。方法 92例直肠癌患者根据应用手术方式不同分为传统组(42例)和TME组(50例), 其中传统组给予传统术式进行手术治疗,而TME组则给予TME治疗。观察两组患者术后临床疗效情况,比较术后局部复发、排尿功能和性功能情况。结果 两组患者手术时间和住院时间差异无统计学意义(P>0.05);传统手术患者术中出血量明显大于TME手术患者,差异有统计学意义(P<0.05);传统组并发症率为7.1%;TME组并发症率为6.0%,两组差异无统计学意义(P>0.05);TME组患者对比传统手术组患者膀胱功能障碍、性功能减退、勃起障碍和射精障碍发生率明显降低,差异有统计学意义(P<0.05);TME组患者对比传统组患者局部复发率明显下降,差异有统计学意义(P<0.05);3年存活率明显提高,差异亦有统计学意义(P<0.05)。结论 针对直肠癌患者给予TME治疗临床疗效显著,能够有效降低术中出血量,改善排尿功能和性功能,有利于降低局部复发率和提高3年存活率。

Comparison of local recurrence and influence on urinary function and sexual function between traditional operation and TEM on treatment of rectal cancer

Objective To observe and compare the clinical effects of traditional operation and total mesorectal excision (TME) on the treatment of rectal cancer, and to compare and analyze the influence on local recurrence, urinary function, and sexual function, in order to provide objective proof for the treatment rectal cancer. Methods 92 cases of patients with rectal cancer were selected as observed object and divided into traditional group (42 cases) and TME group (50 cases) based on different operation methods. The traditional group was given traditional operation, while the TME group was given total mesorectal excision. Postoperative clinical effects of both groups were observed; local recurrence, urinary function, and sexual function were compared. Results There was no significant differences in operation time and hospital stay of both groups(P>0.05); blood loss of traditional group was significantly greater than that of TME group, and the difference was significant(P<0.05); complication rate of the traditional group was 7.1%, while that of TME group was 6.0%, and the difference was not significant(P>0.05); the recurrence rate of bladder dysfunction, sexual dysfunction, erectile dysfunction, and ejaculation disorders of TME group was reduced significantly, and the difference was significant(P<0.05); local recurrence rate of TME group was significantly lower than that of the traditional group, and the difference was significant(P<0.05); 3-year survival rate was significantly improved, and the difference was also statistically significant(P<0.05). Conclusion The clinical effect of TME on the treatment of rectal cancer is significant, which can effectively reduce the blood loss, improve sexual function and urinary function. At the same time, the long-term effects help reducing local recurrence rate and improving 3-year survival rate, which is worth clinical promotion.