世界复合医学2024，Vol.10Issue(1) ：168-172.DOI:10.11966/j.issn.2095-994X.2024.10.01.46

经肛门取标本的腹腔镜低位前切除术治疗低位直肠癌患者的临床效果及对并发症发生率的影响

Clinical Effect and Complication Rate of Laparoscopic Low Anterior Resection with Anal Sam-pling in the Treatment of Patients with Low Rectal Cancer

张昌稳
世界复合医学2024，Vol.10Issue(1) ：168-172.DOI:10.11966/j.issn.2095-994X.2024.10.01.46
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经肛门取标本的腹腔镜低位前切除术治疗低位直肠癌患者的临床效果及对并发症发生率的影响

Clinical Effect and Complication Rate of Laparoscopic Low Anterior Resection with Anal Sam-pling in the Treatment of Patients with Low Rectal Cancer

张昌稳1
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作者信息

  • 1. 徐州医科大学附属第三医院普外科,江苏徐州 221000
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摘要

目的 探讨经肛门取标本的腹腔镜低位前切除术治疗低位直肠癌患者的临床效果,并观察对并发症发生率的影响.方法 回顾性选取2021年9月—2023年9月徐州医科大学附属第三医院普外科收治的67例低位直肠癌患者的临床资料,按照手术方法的不同进行分组.采用常规腹腔镜低位直肠癌根治术的33例患者为对照组,采用腹部无辅助切口经肛门取标本腹腔镜低位前切除术治疗的34例患者为观察组.对比两组患者的手术相关指标、术后疼痛程度、氧化应激反应水平、炎症因子水平以及术后并发症情况.结果 观察组患者的手术时间长于对照组,术中出血量、肛门排气时间、住院时间均优于对照组,差异有统计学意义(P均<0.05).观察组患者术后24 h、48 h的疼痛评分均低于对照组,差异有统计学意义(P均<0.05).观察组术后的超氧化物歧化酶高于对照组,丙二醛低于对照组,差异有统计学意义(P均<0.05).观察组术后的肿瘤坏死因子α、C反应蛋白低于对照组,白细胞介素-10高于对照组,差异有统计学意义(P均<0.05).观察组未见明显并发症发生,对照组并发症发生率为18.18%,两组比较差异有统计学意义(χ2=4.743,P<0.05).结论 经肛门取标本的腹腔镜低位前切除术治疗低位直肠癌创伤两组比较小,疼痛较轻,术后恢复快,患者氧化应激反应及炎性反应程度较低,对降低并发症发生率有积极意义,但手术持续时间略长,临床可根据患者具体情况选择适合的手术方案.

Abstract

Objective To investigate the clinical effect of laparoscopic low anterior resection with anal sam-pling in the treatment of patients with low rectal cancer,and to observe the effect on the incidence of complica-tions.Methods The clinical data of 67 patients with low rectal cancer admitted to the Department of General Surgery at the Third Affiliated Hospital of Xuzhou Medical University from September 2021 to September 2023 were retrospectively selected.According to different surgical methods,33 patients who received conventional laparoscopic radical resection for low rectal cancer were selected as the control group,and 34 patients who re-ceived laparoscopic low anterior resection without auxiliary incision through the anus were selected as the ob-servation group.The surgical indicators,postoperative pain,oxidative stress,inflammatory factors and postop-erative complications were compared between the two groups.Results Patients in the observation group had a longer operation time than those in the control group,and intraoperative bleeding,anal defecation time,and hospitalization time were all better than those in the control group,and the differences were statistically signifi-cant(all P<0.05).The pain scores of the observation group were lower than those of the control group 24 h and 48 h after surgery,and the differences were statistically significant(both P<0.05).After operation,the superox-ide dismutase in observation group was higher than in control group,the malondialdehyde level was lower in the observation group than in control group,and the differences were significant(both P<0.05).After operation,the levels of tumor necrosis factor α and C-reactive protein in observation group were lower than those in control group,and interleukin-10 level was higher than those in control group,the differences were statistically signifi-cant(all P<0.05).There was no significant complication in the observation group,which was significantly lower than that in the control group(18.18%),and the difference was statistically significant(χ2=4.743,P<0.05).Conclusion Laparoscopic low anterior resection with anal sampling for the treatment of low rectal cancer has less trauma,less pain,faster postoperative recovery,and lower levels of oxidative stress and inflammatory reac-tions in patients,which has positive significance in reducing the incidence of complications.However,the dura-tion of surgery is slightly longer,and suitable surgical programs can be selected according to the specific condi-tions of patients.

关键词

低位直肠癌/腹腔镜/经肛门取标本/氧化应激反应/炎症因子

Key words

Low rectal cancer/Laparoscopy/Taking sampling through the anus/Oxidative stress reac-tion/Inflammatory factor

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出版年

2024
世界复合医学

世界复合医学

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