保肛手术与传统Miles手术治疗低位直肠癌效果比较

摘要

Objective To compare the effects of rectal surgery and conventional surgical in treatment of low colorectal cancer. Methods In Our hospital from January 2008 to August 2013,selected 40 patients with colorectal cancer accepted low of surgical as object, 28 patients were male and 12 cases were female patients,the youngest 36 years old,maximum 76 years.Pathological type:Nine cases were adenocarcinoma,20 cases were differentiated adenocarcinoma, 11 cases were poorly differentiated adenocarcinoma.Dukes stage: A of nine cases,B of 24 cases,C of 7 patients. All the patients were divided into Group I and Group Ⅱ of the 20 cases According to the different treatment methods are,Igroup used rectal surgery,Ⅱgroup used Miles operation using the traditional,,mean operative time, postoperative discharge,hospitalization time.Two groups of patients undergoing complications (fistula,anal stenosis,urinary retention,intra-abdominal infections,intra-abdominal hemorrhage) were compared between two groups. Results The operative time of Ⅰ group was significantly shorter than the control group,and the exhaust time of groupⅠsignificantly earlier than the control group,postoperative hospital stay of group Ⅰ was significantly shorter than the control group, the set of indicators were compared between two groups,the difference was extremely significant(P<0.05 or P<0.01). GroupⅠ patients had no case of anastomotic fistula,intra-abdominal infections and bleeding,the incidence rate of postoperative complications of of group Ⅰ was 5.0%, the incidence rate of postoperative complications of group Ⅱ was 20.0%,,the postoperative concurrent the incidence rate of disease between the two groups,the difference was significant(P < 0.05). Conclusion Colorectal cancer patients with low rectal surgery should be preferred,,with the traditional Miles operation,, shorter operative time,, patients quicker recovery and fewer complications.%目的：比较保肛手术与传统Miles手术治疗低位直肠癌效果。方法将我院2008年1月～2013年8月行手术治疗的低位直肠癌患者40例作为观察对象，其中男性患者28例，女性患者12例，年龄最小36岁，最大76岁；病理分型：高分化腺癌9例，中分化腺癌20例，低分化腺癌11例；Dukes分期：A期9例，B期24例，C期7例。根据治疗方法不同分为Ⅰ组和Ⅱ组各20例，Ⅰ组采用保肛手术，Ⅱ组采用传统Miles手术，比较两组患者平均手术时间、术后排气时间、住院时间；两组患者术后并发症（吻合口瘘、肛门狭窄、尿潴留、腹腔内感染、腹腔内出血）。结果Ⅰ组患者的手术时间明显短于对照组、且Ⅰ组患者术后排气时间明显早于对照组、Ⅰ组术后患者住院时间显著短于对照组，Ⅰ组与Ⅱ组上述指标组间比较，差异具有统计学意义（P＜0.05或P＜0.01）。Ⅰ组患者术后无一例出现吻合口瘘、腹腔内感染及出血，Ⅰ组患者术后并发症的发生率仅5.0%，Ⅱ组患者术后并发症的发生率20.0%%，两组术后并发症发生率组间比较，差异具有统计学意义（P＜0.05）。结论低位直肠癌患者应首选保肛手术，与传统Miles手术相比，具有手术时间短、患者恢复快、术后并发症少等优点。