临床普外科电子杂志 ›› 2023, Vol. 11 ›› Issue (4): 26-.

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开腹手术与腹腔镜低位直肠前切除术治疗老年直肠癌患者的疗效对比

  

  1. 南部战区空军医院 普外科,广东 广州 510000
  • 出版日期:2023-10-01 发布日期:2023-12-20

Comparison of therapeutic effects between open surgery and laparoscopic low anterior rectal resection for elderly patients with rectal cancer

  1. General Surgery Department of the Airforce Hospital of Southern Theater Command, Guangdong Guangzhou 510000, China
  • Online:2023-10-01 Published:2023-12-20

摘要:

目的 研究开腹手术与腹腔镜低位直肠前切除术治疗老年低位直肠癌患者的临床疗效。方法 选取南部战区空军医院2020 年3 月至2022 年3 月收治的80 例低位直肠癌住院患者为研究对象,根据手术方式不同分为观察组(腹腔镜低位直肠前切除术)和对照组(开腹低位直肠前切除术)各40 例。比较两组患者的手术指标、术后恢复情况、并发症发生情况及临床疗效。结果 观察组与对照组的切口长度[(6.13±0.94)cm 比(15.82±1.54)cm]、术中出血量[(56.14±10.35)ml 比(118.33±12.74)ml]、手术时间[(135.32±30.64)min 比(173.62±15.36)min] 有显著差异,但两组淋巴结清扫数[(13.64±2.31) 个比(13.78±2.26) 个,P=0.231] 差异无显著性。观察组与对照组术后排气时间[(1.86±0.58)d 比(3.72±1.34)d]、住院时间[(5.27±1.18)d 比(7.36±2.47)d]、肠道功能恢复时间[(1.86±0.35)d 比(2.83±0.44)d] 差异有显著性。观察组并发症总发生率(2.50%)明显低于对照组(25.00%)(P < 0.05)。所有患者随访12 个月,观察组1 例局部复发(2.5%),远处转移到肝2 例(5%),无死亡患者;对照组局部复发1 例(2.5%),无远处转移和死亡患者,两组差异无显著性(P > 0.05)。结论 老年直肠癌患者采用腹腔镜低位直肠前切除术创伤小,并发症发生率低,患者术后恢复较快。

关键词: 老年, 直肠癌, 腹腔镜, 低位直肠前切除术, 疗效

Abstract:

Objective To compare the clinical efficacy of open and laparoscopic low anterior rectal resection in elderly patients with low rectal cancer. Method A total of 80 patients with low rectal cancer in the Airforce Hospital of Southern Theater Command from March 2020 to March 2022 were selected as the study subjects. Depending on the surgical method, they were divided into an observation group (laparoscopic low anterior rectal resection) and a control group (open low anterior rectal resection), with 40 patients in each group. Compare the surgical indicators, postoperative recovery, incidence of complications, and clinical efficacy between the two groups. Result There were statistically significant differences between the observation group and the control group in incision length [(6.13±0.94) cm vs. (15.82±1.54) cm], intraoperative bleeding volume [(56.14±10.35) ml vs. (118.33±12.74)

ml], and surgical time [(135.32 ± 30.64) min vs. (173.62±15.36)min]. However, there was no statistically significant difference in the number of lymph node dissection between the two groups [(13.64±2.31) vs.(13.78± 2.26), P=0.231]. There were statistically significant differences between the observation group and the control group in postoperative exhaust time [(1.86 ± 0.58)d vs. (3.72 ± 1.34)d], hospital stay time [(5.27 ± 1.18)d vs. (7.36 ± 2.47)d], and intestinal function recovery time [(1.86 ± 0.35)d vs. (2.83 ± 0.44)d]. The total incidence of complications in the observation group (2.50%) was significantly lower than that in the control group (25.00%) (P < 0.05). All patients were followed up for 12 months. In the observation group, 1 case had local recurrence (2.5%), 2 cases had distant metastasis to the liver (5%), and there were no deaths; There was 1 local recurrence (2.5%) in the control group, with no distant metastasis or death, and there was no statistically significant difference between

the two groups (P > 0.05). Conclusion Laparoscopic low anterior rectal resection for elderly rectal cancer patients has low trauma, low incidence of complications, and fast postoperative recovery.

Key words: Elderly, rectal cancer, Laparoscopic, Low anterior rectal resection, Curative effect