Jiang Xingli, Cai Zhenfeng, Dai Xintao, Pan Luofeng
Department of General Surgery, The People's Hospital of Yuhuan, Yuhuan, China.
Department of Anaesthesiology, The People's Hospital of Yuhuan, Yuhuan, China.
J Minim Access Surg. 2024 Jul 1;20(3):258-265. doi: 10.4103/jmas.jmas_122_23. Epub 2024 Jan 19.
To explore the surgical effect and gastrointestinal functional recovery of laparoscopic-guided total mesorectal excision (LGTME) in patients with rectal cancer.
A total of 150 rectal cancer patients who underwent surgical treatment in our hospital from July 2022 to July 2023 were selected and randomly divided into two groups using a random number table. There were 75 cases in the control group (CG) who underwent traditional open rectal total mesorectal excision surgery and 75 cases in the experimental group (EG) who underwent LGTME. The surgical effects of the two groups were compared, and the gastrointestinal and anal functional recovery of the two groups were compared before and after treatment.
Intraoperative bleeding, incision length, time to initial feeding and time to anal exhaust in the EG were significantly lower than those in the CG ( P < 0.05). Before treatment, there was no significant difference in gastrointestinal function and anal function between the two groups ( P > 0.05). After treatment, the levels of motilin, gastrin, neuropeptide Y and basic fibroblast growth factor in the EG were significantly higher than those in the CG, with statistical significance ( P < 0.05); the maximum anal systolic pressure and resting anal sphincter pressure in the EG were significantly lower than those in the CG ( P < 0.05); the rectal sensitivity threshold volume (RSTV) and rectal maximum volume threshold in the EG were significantly higher than those in the CG ( P < 0.05). There was no significant difference in most postoperative complications between the two groups ( P > 0.05).
LGTME improves the surgical effects of rectal cancer patients, promotes the recovery of gastrointestinal function and has a small effect on anal function indicators, thereby reducing hospital stay.
探讨腹腔镜引导下直肠癌全直肠系膜切除术（LGTME）对直肠癌患者的手术效果及胃肠功能恢复情况。
选取2022年7月至2023年7月在我院接受手术治疗的150例直肠癌患者，采用随机数字表法将其随机分为两组。对照组（CG）75例，行传统开放性直肠癌全直肠系膜切除术；实验组（EG）75例，行LGTME。比较两组的手术效果，并比较两组治疗前后的胃肠及肛门功能恢复情况。
实验组术中出血量、切口长度、首次进食时间及肛门排气时间均显著低于对照组（P<0.05）。治疗前，两组胃肠功能和肛门功能无显著差异（P>0.05）。治疗后，实验组胃动素、胃泌素、神经肽Y和碱性成纤维细胞生长因子水平显著高于对照组，差异有统计学意义（P<0.05）；实验组肛门最大收缩压和静息肛门括约肌压力显著低于对照组（P<0.05）；实验组直肠感觉阈值容积（RSTV）和直肠最大容积阈值显著高于对照组（P<0.05）。两组术后多数并发症无显著差异（P>0.05）。
LGTME改善了直肠癌患者的手术效果，促进了胃肠功能的恢复，对肛门功能指标影响较小，从而缩短了住院时间。
