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目的研究腹腔镜全直肠系膜切除术与传统手术治疗直肠癌的效果。方法选取160例直肠癌患者,按照随机数字表法分为观察组和对照组,每组80例,对照组采用传统的直肠癌根治术,观察组采用腹腔镜全直肠系膜切除术。观察两组患者的治疗效果,包括手术时间、肠道功能恢复时间、术后下床时间、住院时间、出血量及不良反应情况,包括局部复发率、泌尿功能障碍、性功能减退、博起障碍、射精障碍、阴道疼痛等,以及1年期生存率、2年期生存率、保肛率等情况。结果观察组患者手术时间明显比对照组长,肠道功能恢复时间、术后下床时间、住院时间、出血量明显优于对照组,差异均有统计学意义(P<0.05);观察组患者的局部复发率、泌尿功能障碍、性功能减退、勃起障碍、射精障碍、阴道疼痛情况均优于对照组,差异有统计学意义(P<0.05);观察组2年期生存率明显高于对照组,差异有统计学意义(P<0.05)。结论直肠癌应用全直肠系膜切除术治疗,与传统的直肠癌根治术相比,能够明显提高治疗效果,减少并发症,延长患者生存期,值得在临床上推广应用。
Objective To investigate the effect of laparoscopic total mesorectal excision and traditional surgical treatment of rectal cancer. Methods One hundred and sixty patients with rectal cancer were divided into observation group and control group according to the random number table method. 80 cases in each group. The control group used traditional radical resection of the rectal cancer. The observation group used laparoscopic total mesorectal excision. Observe the treatment effects of the two groups of patients, including the operation time, intestinal function recovery time, postoperative bed-out time, hospitalization time, blood loss and adverse reactions, including local recurrence rate, urinary dysfunction, sexual dysfunction, and disorders , ejaculation disorders, vaginal pain, etc., as well as 1-year survival rate, 2-year survival rate, and sphincter preservation rate. Results The observation time was significantly longer in the observation group than in the control group. The recovery time of the intestinal function, postoperative bed-out time, length of hospital stay, and blood loss were significantly better than those in the control group (P<0.05). The local recurrence rate, urinary dysfunction, sexual dysfunction, erectile dysfunction, ejaculatory dysfunction, and vaginal pain were all better than those in the control group (P<0.05). The 2-year survival rate in the observation group was significantly higher than that in the control group. In the group, the difference was statistically significant (P<0.05). Conclusion The application of total mesorectal excision for rectal cancer treatment can significantly improve the therapeutic effect, reduce the complications and prolong the survival of patients compared with the traditional radical resection of rectal cancer. It is worthy of being popularized and applied in clinical practice.