Abstract:【Objective】To investigate the effect of laparoscopic assisted total mesorectal excision on the prognosis of patients with advanced middle and low rectal cancer.【Methods】A total of 120 patients with advanced middle and low rectal cancer in our hospital were divided into control group (n=60, total mesorectal excision) and observation group (n=60, laparoscopic assisted total mesorectal excision) according to different treatment methods. Two groups of patients were compared in terms of surgical related indicators, postoperative KPS score, incidence of complications, and prognosis. 【Results】Compared with the control group, the observation group had shorter surgical time and first postoperative exhaust time, while the observation group had less intraoperative bleeding than the control group (P<0.05). After treatment, the KPS scores of both groups of patients improved compared to before treatment, and the KPS scores of the observation group were higher than those of the control group (P<0.05). The total incidence of complications during the treatment period in the observation group was 5.00% (3/60), lower than the 16.67% (10/60) in the control group (P<0.05). The distant metastasis rate and local recurrence rate of the observation group were 3.33% (2/60) and 1.67% (1/60), both lower than the control group's 13.33% (8/60) and 11.67% (7/60), and the differences between the two groups were statistically significant (both P<0.05). 【Conclusion】Laparoscopic assisted transanal total mesorectal excision has a good effect, which is conducive to promoting the rehabilitation of patients with advanced middle and low rectal cancer, further improving their quality of life, and reducing the incidence of complications, distant metastasis and local recurrence.
钟广俊, 刘春华, 潘生华, 王兆军. 腹腔镜辅助经肛门全直肠系膜切除术对进展期中低位直肠癌患者预后的影响[J]. 医学临床研究, 2023, 40(7): 1057-1059.
ZHONG Guang-jun, LIU Chun-hua, PAN Sheng-hua, et al. Effect of Laparoscopic Assisted Transanal Total Mesorectal Excision on the Prognosis of Patients with Advanced Middle and Low Rectal Cancer. JOURNAL OF CLINICAL RESEARCH, 2023, 40(7): 1057-1059.
[1] TREPANIER J S, LACY F B, LACY A M. Transanal total mesorectal excision:description of the technique[J].Clin Colon Rectal Surg,2020,33(3):144-149. [2] UEMATSU D, AKIYAMA G, SUGIHARA T, et al. Transanal total mesorectal excision in the prone jackknife position without being conscious of the size of prostatic enlargement for lower rectal cancer[J].Int Cancer Conf J,2020, 9(3):107-111. [3] REYNGOLD M, NILAND J, Ter VEER A, et al. Trends in intensity modulated radiation therapy use for locally advanced rectal cancer at National Comprehensive Cancer Network centers[J].Adv Radiat Oncol,2017, 3(1):34-41. [4] KNOL J, KELLER D S. Total mesorectal excision technique-past, present, and future[J].Clin Colon Rectal Surg,2020, 33(3):134-143. [5] CAMICHAEL H, SYLLA P. Evolution of transanal total mesorectal excision[J].Clin Colon Rectal Surg,2020, 33(3):113-127. [6] 中华医学会消化内镜学分会,中国抗癌协会肿瘤内镜学专业委员会.中国早期结直肠癌筛查及内镜诊治指南(2014,北京)[J].中华医学杂志, 2015, 95(28):2235-2252. [7] WIJNANDS A M, de JONG M E, LUTGENS M W M D, et al. Prognostic factors for advanced colorectal neoplasia in inflammatory bowel disease:systematic review and meta-analysis [J].Gastroenterology,2021, 160(5):1584-1598. [8] CAO B, MIN L, ZHU S, et al. Long-term oncological outcomes of local excision versus radical resection for early colorectal cancer in young patients without preoperative chemoradiotherapy:a population-based propensity matching study[J].Cancer Med,2018,7(6):2415-2422. [9] VAUGHAN A, de PASSILLE A M, STOOKEY J, et al. Urination and defecation by group-housed dairy calves[J].J Dairy Sci,2014, 97(7):4405-4411. [10] 龙飞,欧阳军,陈向恒,等. 腹腔镜辅助经肛全直肠系膜切除术治疗中低位直肠癌的临床分析(附32例报告)[J].中国内镜杂志,2020,26(2):11-18. [11] 刘晓辉,朱晓峰,王伟,等. 腹腔镜辅助经肛全直肠系膜切除术与腹腔镜全直肠系膜切除术治疗低位直肠癌的疗效比较[J].中国普通外科杂志,2020,29(10):1165-1171. [12] 姚宏伟,安勇博,王权,等. 腹腔镜辅助经肛全直肠系膜切除术治疗低位直肠癌近期疗效的前瞻性和多中心病例登记研究[J].中华消化外科杂志,2021,20(12):1351-1357.