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岭南现代临床外科 ›› 2022, Vol. 22 ›› Issue (05): 458-462.DOI: 10.3969/j.issn.1009-976X.2022.05.005

• 论著与临床研究 • 上一篇    下一篇

盆底腹膜重建对直肠癌患者微创低位前切除手术效果的影响

孙振芝, 黄建峰, 王涛, 靳继韬, 聂勇, 于桂巧   

  1. 武警北京市总队医院外一科,北京 100027
  • 通讯作者: *孙振芝,Email:bbgirl2017@126.com

Effect of pelvic floor peritoneal reconstruction on minimally invasive low anterior resection in patients with rectal cancer

SUN Zhen-zhi, HUANG Jian-feng, WANG Tao, JIN Ji-tao, NIE Yong, YU Gui-qiao   

  1. Department of Surgery, Outer Family, Armed Police Beijing Corps Hospital, Beijing 100027
  • Received:2022-03-02 Online:2022-10-20 Published:2022-12-06
  • Contact: SUN Zhen-zhi, bbgirl2017@126.com

摘要: 目的 探索盆底腹膜重建对直肠癌患者微创低位前切除手术效果及并发症的影响。方法 选择2017年1月至2021年1月期间于武警北京市总队医院接受微创低位前切除术治疗的128例直肠癌患者作为研究对象,根据手术方式将研究对象分成两组,64例实施盆底腹膜重建手术的患者为观察组,64例未实施盆底腹膜重建的患者为对照组,随访6个月。对比分析两组的手术效果及围术期指标。结果 观察组患者手术时间明显高于对照组(P<0.05)。观察组术后住院时间明显低于对照组(P<0.05)。观察组并发症总发生占比明显低于对照组(P<0.05)。观察组二次手术率明显低于对照组(P<0.05)。两组术后1 d、3 d、5 d的血C反应蛋白、降钙素原水平无显著性差异(P>0.05),两组术后第3 d的血C反应蛋白和降钙素原水平均低于术后1 d(P<0.025)。观察组术后、术后1个月以及术后6个月的大便功能评分均显著低于对照组术后、术后1个月以及术后6个月时(P<0.05)。结论 盆底腹膜重建能够使得实施微创低位切除手术的直肠癌患者Ⅲ~Ⅳ级并发症发生风险降低,同时也减少了二次手术的发生率,患者体内的炎性反应得到抑制,对患者的预后具有促进作用。

关键词: 盆底腹膜重建, 直肠癌, 微创低位前切除术, 并发症

Abstract: Objective To explorethe effect of pelvic floor peritoneal reconstruction on the effect and complications of minimally invasive low anterior resection in patients with rectal cancer. Methods 128 patients with rectal cancer who received minimally invasive low anterior resection in our hospital from January 2017 to January 2021 were selected as the research subjects, and the subjects were divided into two groups according to the surgical method, and 64 cases underwent pelvic floor peritoneal reconstruction surgery 64 patients without pelvic floor peritoneal reconstruction were included in the control group and were followed up for 6 months. The surgical results and perioperative indicators of the two groups were compared and analyzed. Results The operation time of the observation group was significantly higher than that of the control group (P<; 0.05). The postoperative hospital stay in the observation group was significantly lower than that in the control group (P<; 0.05). The incidence of anastomotic leakage, grade C anastomotic leakage, abdominal infection, pelvic infection and intestinal obstruction in the observation group was lower than that in the control group, and the total incidence of complications in the observation group was significantly lower than that in the control group (P<; 0.05). The second operation rate in the observation group was significantly lower than that in the control group (P<; 0.05). There was no significant difference in serum C-reactive protein and procalcitonin levels between the two groups at 1, 3, and 5 days after operation (P>; 0.05). The original level was lower than 1 day after operation (P<; 0.025). The stool function scores of the observation group after operation, 1 month after operation and 6 months after operation were significantly lower than those in the control group after operation, 1 month after operation and 6 months after operation (P<; 0.05). Conclusion Pelvic floor peritoneal reconstruction can greatly reduce the risk of grade Ⅲ~Ⅳ complications in patients with rectal cancer who undergo minimally invasive low resection, and also reduce the incidence of secondary surgery. Prognosis is facilitative.

Key words: pelvic floor peritoneal reconstruction, rectal cancer, minimally invasive low anterior resection, complications

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