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目的比较中低位直肠癌实施Dixon手术中,使用双吻合器吻合与人工吻合的疗效。方法回顾性分析接受Dixon手术治疗的中低位直肠癌患者84例,按照吻合技术,分为双吻合器组56例和人工吻合组28例;比较2组的手术时间、术中失血量及术后并发症发生率;随访3年,比较肿瘤复发率及生存率。结果 2组肿瘤分期差异无统计学意义(P>0.05)。双吻合器组手术时间为(102.7±11.2)min,明显少于人工吻合组(167.0±12.7)min(P<0.01);术中失血量也少于人工吻合组[(180.4±45.4)mL vs(327.5±57.0)mL,P<0.01]。双吻合器组术后并发症发生率为10.7%(6/56),人工吻合组为1 7.8%(5/28),差异无统计学意义(P>0.05)。双吻合器组3年肿瘤复发率为5.5%,3年生存率为96.4%;人工吻合组分别为8%、96.0%;2组相比差异均无统计学意义(P>0.05)。结论与人工吻合相比,双吻合器可明显缩短手术时间、减少术中失血量;但是不能降低术后并发症发生率、3年肿瘤复发率,不能提高3年生存率。
Objective To compare the curative effect of double stapling anastomosis and artificial anastomosis in middle and low rectal cancer during Dixon operation. Methods A total of 84 patients with low and middle rectal cancer undergoing Dixon surgery were retrospectively analyzed. According to the anastomosis technique, 56 cases were divided into double stapling group and 28 cases of artificial anastomosis group. The operation time, intraoperative blood loss and postoperative The incidence of complications was followed up for 3 years to compare the tumor recurrence rate and survival rate. Results There was no significant difference in tumor staging between the two groups (P> 0.05). The operation time of the double stapling group was (102.7 ± 11.2) min, which was significantly lower than that of the artificial anastomosis group (167.0 ± 12.7) min (P <0.01). The intraoperative blood loss was also less than that of the artificial anastomosis group [(180.4 ± 45.4) mL vs (327.5 ± 57.0) mL, P <0.01]. The incidence of postoperative complications in double stapler group was 10.7% (6/56) and in artificial anastomosis group was 1 7.8% (5/28), with no significant difference (P> 0.05). In the double stapling group, the recurrence rate was 3.5% at 3 years and 96.4% at 3 years. The rate of artificial anastomosis was 8% and 96.0% respectively. There was no significant difference between the two groups (P> 0.05). Conclusion Compared with manual anastomosis, double stapler can shorten the operation time and reduce intraoperative blood loss; but can not reduce the incidence of postoperative complications, 3-year tumor recurrence rate, can not improve the 3-year survival rate.