临床外科杂志 ›› 2026, Vol. 34 ›› Issue (6): 671-674.doi: 10.3969/j.issn.1005-6483.20250798

• 论著 • 上一篇    下一篇

腹腔镜下中低位直肠癌根治术中不同吻合口加固方式的效果评价

毕亭亭,丁子明,李永,张前进,刘岩   

  1. 东南大学附属徐州市中心医院消化病科
  • 收稿日期:2025-08-06 出版日期:2026-08-18 发布日期:2026-08-18
  • 通讯作者: 刘岩
  • 作者简介:毕亭亭,丁子明,李永,张前进,刘岩
  • 基金资助:
    江苏省徐州医科大学附属医院优秀人才基金项目(XYFY2020009)

Effect evaluation of different reinforcement methods of anastomosis in laparoscopic radical resection of middle-low rectal cancer

BI Tingting,DING Ziming,LI Yong,ZHANG Qianjin,LIU Yan   

  1. Center for Digestive Diseases,Xuzhou Central Hospital Affiliated to Southeast University
  • Received:2025-08-06 Online:2026-06-20 Published:2026-08-18

摘要: 目的 探讨腹腔镜下中低位直肠癌根治术中不同吻合口加固方式的效果及其对并发症的影响。方法 2020年2月~2024年11月行腹腔镜下直肠癌根治术联合吻合口缝合加固的中低位直肠癌病人84例,按吻合方式不同分成两组,观察组44例,行吻合口全层整圈加固缝合;对照组40例,行吻合口前壁的连续加固缝合,比较两组病人手术相关指标、术后第3天炎症水平及术后并发症的发生情况。结果 两组病人手术时间、术中出血量、首次排气时间、肛管拔除时间、住院时间比较,差异无统计学意义(P均>0.05)。观察组手术时间为(126.36±25.82)分钟,长于对照组的(116.38±22.76)分钟,两组比较差异有统计学意义(P<0.05)。两组病人术后第3天C-反应蛋白(CRP)、白细胞计数(WBC)、淋巴细胞(Lym)、白细胞介素(IL)-6等炎性指标比较,差异无统计学意义(P>0.05);两组病人吻合口漏、吻合口出血、切口感染、尿潴留、吻合口狭窄等并发症发生率比较,差异无统计学意义(P均>0.05)。但观察组吻合口狭窄发生比例高于研究组(9.09% vs. 0)。结论 对于在腹腔镜下行中低位直肠癌根治术的病人,行吻合口前壁加固缝合操作相对简单,减少手术时间,降低吻合口狭窄的发生,且不增加并发症的发生率。

关键词: 加固缝合; 中低位直肠癌; 腹腔镜手术; 效果评价

Abstract: Objective To explore the effects of different suture methods in anastomotic stoma in laparoscopic radical resection of middle-low rectal cancer and their influences on complications. Methods From February 2020 to November 2024,84 patients with middle-low rectal cancer were selected and divided into two groups according to different reinforcement methods of the anastomosis.44 cases in the observation group were treated with full-thickness reinforcement suture of the anastomotic stoma,while 40 cases in the control group were treated with continuous reinforcement suture of the anterior wall of the anastomotic stoma.The surgical related indexes,inflammation levels on the third postoperative day,and postoperative complications of the two groups were compared. Results There was no statistical difference in operation time,intraoperative blood loss,first exhaust time,anal canal removal time and hospital stay between the two groups (P>0.05).The operation time of the observation group was (126.36±25.82) minutes,which was longer than that of the control group (116.38±22.76) minutes.There was a statistically significant difference between the two groups (P<0.05).There was no significant difference in inflammatory indexes such as c-reactive protein (CRP),white blood cells (WBC),lymphocytes (Lym) and interleukin -6(IL-6) between the two groups (P>0.05).There was no statistical difference in the incidence of postoperative complications between the two groups,such as anastomotic leakage,anastomotic bleeding,incision infection,urinary retention and anastomotic stenosis(all P>0.05),but the incidence of anastomotic stenosis in the observation group was significantly higher than that in the research group (9.09% vs. 0). Conclusion For patients undergoing laparoscopic radical resection of middle and low rectal cancer,the operation of reinforcing and suturing the anterior wall of anastomosis is relatively simple,which can not only shorten the operation time appropriately,but also reduce the occurrence of anastomotic stenosis without increasing other complications,and is safe and effective.

Key words: reinforcement suture; middle-low rectal cancer; laparoscopic surgery; effectivenes evaluation

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