自制平台腔镜下经肛辅助入路全直肠系膜切除术在中低位直肠癌患者中的应用效果

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Abstract Objective To observe the effect of percutaneous transanal assisted total mesorectal excision (TME) in patients with moderate-low rectal cancer. Methods From June 2016 to June 2018, 45 cases of moderate-low rectal cancer patients admitted to the General Surgery People′s Hospital of Baise were selected and divided into two groups by the random number table method. There were 20 patients in the observation group and 25 patients in the control group. The control group was treated with conventional laparoscopic TME, and the observation group was treated with self-made platform laparoscopic transanal approach and transabdominal TME. The surgically related indicators and rectal surgical specimens were compared in the two groups. Treatment-related costs of the two groups were compared. Follow-up statistics and comparison of postoperative complications, recurrences, and deaths were compared and compared in the two groups. Results There was no significant difference in operation time, length of rectum resection, length of distal tumor resection margin, number of lymph node dissection, mesenteric integrity and negative rate of resection margin between the two groups (P ＞ 0.05). Intraoperative blood loss in the observation group was less than that in the control group, the incidence of complications was lower than that in the control group, and the time of anal exhaust and hospital stay were shorter than that in the control group, with statistically significant differences (P ＜ 0.05). The costs of operation and hospitalization in the observation group were significantly lower than those in the control group, with statistically significant differences (P ＜ 0.05). Two cases were lost to follow-up in the two groups, and the follow-up period was 3 months to 2 years. No recurrence or death occurred in the two groups during the follow-up period. Conclusion Compared with laparoscopic TME in the treatment of middle and low rectal cancer under self-made platform endoscopy, TME through anal assisted approach has similar operation time and surgical resection of rectum, but the former has many advantages, such as small intraoperative blood loss, fast postoperative recovery, low cost and few complications, and is worthy of promotion.

Key words： Moderate-low rectal cancer Transanal approach Laparoscopy Total mesorectal excision

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WANG Yuncheng ZHAI Gang QIN Chuan. Application of self-made laparoscopic transanal assisted total mesorectal excision in patients with middle and low rectal cancer[J]. 中国医药导报, 2019, 16(17): 109-112,128.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I17/109

[1] 杜灵彬，李辉章，王悠清，等.2013年中国结直肠癌发病与死亡分析[J].中华肿瘤杂志，2017，39（9）：53-59.
[2] 董博，黄博，董永红，等.腹腔镜与开腹全直肠系膜切除术治疗直肠癌的临床比较[J].肿瘤研究与临床，2016，28（10）：679-682.
[3] Park IJ，Yu CS，Lim SB，et al. IsPreoperative Chemoradiotherapy Beneficial for Sphincter Preservation in Low-LyingRectal Cancer Patients? Medicine （Baltimore） [J]. 2016， 95（18）：34-39.
[4] 邱辉忠，肖毅，徐徕，等.经肛门内镜联合腹腔镜全直肠系膜切除治疗低位直肠癌的安全性和可行性[J].中华胃肠外科杂志，2016，19（1）：41-44.
[5] 姚宏伟，刘荫华.第7版结直肠癌TNM分期（2010）更新内容解读[J].中华外科杂志，2010，48（21）：1601-1604.
[6] 周锡庚，郁宝铭.结、直肠癌Dukes病理分期的改进[J].上海医学，1982（6）.
[7] 周总光，王自强.欧美与日本中低位直肠癌诊治指南解读[J].中国实用外科杂志，2009，29（4）：291-292.
[8] Goebel EA，Stegmaier M，Gorassini DR，et al. Grading of Total Mesorectal Excision Specimens：Assessment of Interrater Agreement [J]. Dis Colon Rectum，2018，61（6）：686-691.
[9] 于滨，于跃明，陈砚凝，等.中低位直肠癌系膜环周切缘癌浸润的病理学研究[J].中华外科杂志，2009，47（22）：1689-1692.
[10] 池畔，王枭杰.论经肛全直肠系膜切除术能否做到真正的全直肠系膜切除术[J].中华消化外科杂志，2018，17（2）：127-132.
[11] Park EJ，Baik SH，Kang J，et al. The Impact ofPostoperative Complications on Long-term Oncologic Outcomes After LaparoscopicLow Anterior Resection for Rectal Cancer [J]. Medicine（Baltimore），2016，95（14）：32-37.
[12] 郑民华，马君俊.腹腔镜结直肠手术手术入路选择专家共识[J].中国实用外科杂志，2017，37（4）：415-419.
[13] 黄斌，张玉茹，刘连成，等.结肠镜辅助腹腔镜手术治疗结直肠息肉疗效分析[J].中国中西医结合外科杂志，2017， 23（1）：82-84.
[14] 江珊，池畔.直肠癌根治术中骶前静脉丛大出血的防治[J].结直肠肛门外科，2006，12（1）：26-28.
[15] 庞辉，岳秀英.妇科腹腔镜手术能量器械常见副损伤及防治[J].国际妇产科学杂志，2017，44（4）：468-472.
[16] Han J，Shi C，Dong X，et al. Laparoscopicabdomino-perineal resection for patients with anorectal malignant melanoma：areport of 4 cases [J]. J Biomed Res，2016，30（5）：436-440.
[17] 孔杰，甘从存，徐士杰，等.中低位直肠癌全直肠系膜切除术后吻合口瘘的危险因素分析[J].中国普外基础与临床杂志，2016，23（2）：210-213.
[18] 韩方海，李洪明.直肠癌保肛手术中副损伤的预防和术后并发症的处理[J].中华胃肠外科杂志，2016，19（6）：624-629.
[19] Mari G，Costanzi A，Galfrascoli E，et al. Prospective Evaluation of Genito-Urinary Function after Laparoscopic RectalResection in the Elderly [J]. Chirurgia （Bucur），2016， 111（4）：318-325.
[20] 徐小群，许多，施若霖.经肛辅助腹腔镜下TME治疗低位直肠癌手术术中护理问题及对策[J].浙江医学，2017， 39（17）：1491-1493.