摘要
Abstract
Objective To compare the effects of three kinds of operation in the treatment of low rectal cancer.Methods The clinical data of 146 patients who had suffered from low rectal cancer and received surgical treatment were analyzed retrospectively and divided into three groups according to the operation methods:38 patients who received total mesorectal excision(TME) with pelvic autonomic nerve plexus(PANP) reserved constituted a TME-PANP group,51 patients who received transabdominal anterior resection of rectal cancer (Dixon) constituted a Dixon group,and 57 patients who received abdominoperineal resection of rectal cancer (Miles) constituted a Miles group.The operation time and length of stay (LOS) among the three groups were compared.Quality of life scales (PAC-QOL) were issued one year before and after operation to evaluate patients' quality of life.Patients' urinary function and sexual function in male patients were evaluated one year after operation.The three-year survival rate,local recurrence and distant metastasis rate among the three groups were compared.Results There were significant difference in the operation time and LOS among the three groups(P ＜ 0.05).The operation time and LOS in the TME-PANP group were the shortest,followed by those in the Dixon group,and those in the Miles group were the longest.One year after operation,the quality of life in the three groups decreased significantly (P ＜ 0.05).The PAC-QOL scores in the TME-PANP group were the lowest,followed by those in the Dixon group,and those in the Miles group were the highest;the ratios of Grade Ⅰ post-operative urinary function and ejaculatory function in the TME-PANP group were 71.05％ and 68.18％ respectively,significantly higher than those in the Dixon group (43.14％ and 35.48％) and in the Miles group (22.81％ and 22.22％)(P ＜ 0.05);the ratio of Grade Ⅰ erection function in the TME-PANP group was 63.64％,higher than that (25.00％) in the Miles group(P ＜ 0.05).There was no difference between the other two groups (P ＞ 0.05).The post-operative three-year survival rate,local recurrence rate and distant metastasis rate among the three groups showed no significant difference (P ＞ 0.05).Conclusion TME-PANP can significantly improve patients' post-operative urinary function and sexual function in male patients and shorten post-operative recovery time,and is worthy of clinical popularization.关键词
低位/直肠癌/TME-PANP术/Dixon术/Miles术/排尿功能Key words
low rectal cancer/TME-PANP/Dixon/Miles/urinary function分类
医药卫生
