论文部分内容阅读
目的探讨末端回肠悬吊术在低位直肠癌保肛手术中的应用价值。方法选取2015年6月至2017年2月我院诊断为低位直肠癌患者80例,随机分为两组:对照组(C组)和试验组(T组),每组各40例。C组行腹腔镜下直肠癌根治术(Dixon),T组在C组基础上联合末端回肠悬吊术。分别于术前1 d和术后第1、3、7天检测两组营养学指标:血浆总蛋白(TP)、血清白蛋白(ALB)、血清前白蛋白(PA)、转铁蛋白(TF);外周血电解质:钠(Na~+)、钾(K~+)、氯(Cl~-)等水平,并记录术后首次排气时间、术后住院时间、住院总费用及术后并发症等。结果两组术前和术后营养指标及血电解质水平差异无统计学意义(P>0.05);术后肛门首次排气时间、术后住院时间、住院总费用及并发症发生率方面差异亦无统计学意义(P>0.05);T组吻合口瘘的二次手术率明显低于C组,差异有统计学意义(P<0.05)。结论末端回肠悬吊术不影响患者术后恢复,不增加患者的痛苦及经济负担,能有效降低由吻合口瘘所致的二次手术率,而且操作简便。
Objective To investigate the value of distal ileal suspension in anus-preserving operation for low rectal cancer. Methods Eighty patients with low rectal cancer diagnosed in our hospital from June 2015 to February 2017 were randomly divided into two groups: control group (C) and test group (T), with 40 cases in each group. In group C, laparoscopic resection of rectal cancer (Dixon) and group T were performed on the basis of group C combined with terminal ileal suspension. The two groups of nutritional indicators were detected on the 1st day before surgery and on the 1st, 3rd and 7th days after surgery: plasma total protein (TP), serum albumin (ALB), serum prealbumin (PA), transferrin (TF Peripheral blood electrolytes: sodium (Na~+), potassium (K~+), chlorine (Cl~-) and other levels, and record the first postoperative exhaust time, postoperative hospital stay, total hospital expenses, and postoperative concurrent Symptoms and so on. Results There were no significant differences in preoperative and postoperative nutritional indicators and blood electrolyte levels between the two groups (P>0.05). There was no difference in postoperative anal exhaust time, postoperative hospital stay, total hospital expenses, and complication rate. Statistical significance (P>0.05); The reoperation rate of anastomotic fistula in group T was significantly lower than that in group C, and the difference was statistically significant (P<0.05). Conclusions End-to-end ileal suspension does not affect postoperative recovery, does not increase patient’s pain and financial burden, can effectively reduce the rate of secondary surgery caused by anastomotic leakage, and is easy to operate.