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低位直肠癌中 LAR 与 VLAR 的对比——术后结果——单中心经验

LAR vs VLAR in Low Rectal Cancer - Postoperative Results - A Single-Center Experience.

出版信息

Chirurgia (Bucur). 2021 May-Jun;116(3):321-330. doi: 10.21614/chirurgia.116.3.321.

Abstract

The management of rectal cancer recognizes surgical resection as the most important step towards a permanent cure. Respecting the oncological principles, functional preservation represents a priority in achieving an acceptable quality of life for the patient. This study aimed to compare the results after low anterior resection (LAR) versus very low anterior resection (VLAR), in terms of postoperative outcome. We conducted a retrospective, observational study on a group of 147 patients with LAR or VLAR done for low rectal cancer in the 1st Department of General Surgery of the Emergency County Hospital of Targu Mures, between January 2015 and December 2019. We considered as low rectal cancer tumors located between 5-10 cm from the anal verge and very low those situated less than 5 cm from it. Patients were divided in two groups according to the type of operation. The postoperative evolution was followed. The two groups, LAR with 81 and VLAR with 66 cases, had homogenous distribution regarding patients demographic and biological parameters and tumor pathological features. A significantly (p=0.0223) longer surgical intervention time was reported in VLAR than in LAR procedures. We found no statistically significant differences between LAR and VLAR in terms of associated postoperative morbidity or mortality, neither in hospitalization time. There was no statistical difference in terms of early postoperative outcomes among LAR and VLAR. The most important factor in achieving good oncologic and functional results in low rectal cancer is choosing the adequate, tailored to the case surgical management.

摘要

直肠癌的治疗方法以手术切除为主,这是实现根治的最重要手段。在保证肿瘤学原则的前提下,尽可能地保留功能是提高患者生活质量的关键。本研究旨在比较低位前切除术(LAR)与极低位前切除术(VLAR)在术后结果方面的差异。

我们对 2015 年 1 月至 2019 年 12 月在穆列什紧急县医院普外科 1 科接受 LAR 或 VLAR 治疗的 147 例低位直肠癌患者进行了回顾性、观察性研究。我们将肿瘤距肛缘 5-10cm 定义为低位,<5cm 定义为极低位。根据手术类型将患者分为两组。观察术后演变。

LAR 组 81 例,VLAR 组 66 例,两组患者的人口统计学和生物学参数以及肿瘤病理特征分布均匀。VLAR 组的手术时间明显长于 LAR 组(p=0.0223)。LAR 组和 VLAR 组在术后并发症或死亡率以及住院时间方面无统计学差异。

LAR 组和 VLAR 组在术后早期结果方面无统计学差异。在低位直肠癌的治疗中,选择合适的手术方式是取得良好肿瘤学和功能学结果的关键。

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