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外科研究与新技术（中英文）

外科研究与新技术 ›› 2023, Vol. 12 ›› Issue (1): 10-13.doi: 10.3969/j.issn.2095-378X.2023.01.003

• 论著 • 上一篇    下一篇

结直肠癌患者应用腹腔镜行根治术的临床效果观察

王盼, 杨秀春   

  1. 北京市平谷区中医医院外科,北京 101200
  • 收稿日期:2022-10-11 发布日期:2023-05-26
  • 作者简介:王盼（1982—）,男,大学本科,副主任医师,从事临床外科工作;电子信箱：wangpan989@163.com

Clinical effect of laparoscopic radical resection on colorectal cancer

WANG Pan, YANG Xiuchun   

  1. Department of Surgery, Beijing Pinggu Hospital of Traditional Chinese Medicine, Beijing 101200, China
  • Received:2022-10-11 Published:2023-05-26

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摘要： 目的 观察结直肠癌（CRC）患者应用腹腔镜行根治术的临床效果。方法 回顾性分析2018年1月—2021年3月收治的结直肠癌患者60例CRC患者按照手术治疗方法的不同分成对照组和观察组,各30例,对照组采取开腹手术,观察组采取腹腔镜根治术,观察对比两组手术指标、术后恢复指标、炎症因子指标、胃肠道激素水平、术后并发症情况和1年后生存率。结果 两组手术时间、淋巴结清扫数量均无显著性差异（P>0.05）,观察组术中出血量少于对照组、手术切口长度短于对照组（均P<0.01）;观察组术后腹胀持续时间、肛门排气时间、首次进食时间、住院时间均明显短于对照组（均P<0.01）;术前两组血清炎症因子水平均无明显差异（P>0.05）,术后1 d、3 d、7 d两组IL-6、IL-8、IL-10及C反应蛋白（CRP）水平,观察组均明显优于对照组（均P<0.01）;术前两组血清胃动素、胃泌素水平均无明显差异（P>0.05）,术后观察组胃动素、胃泌素水平明显高于对照组（均P<0.01）;观察组术后并发症的出现频率明显低于对照组（P<0.05）。经过1年时间的随访,观察组的生存率为80.0%（24/30）,对照组为76.67%（23/30）,组间比较无明显差异（P>0.05）。结论 与开腹手术相比,腹腔镜根治术对于CRC患者在保障手术治疗效果的前提下,对胃肠功能的影响较轻微,造成损伤炎症更小,术后并发症更少、恢复更快,具有较高的推广价值。

关键词: 腹腔镜, 根治术, 结直肠癌, 胃肠激素, 炎症因子, 临床效果

Abstract: Objective To observe the clinical effect of laparoscopic radical resection on colorectal cancer (CRC). Methods Retrospective analysis of 60 CRC patients admitted from January 2018 to March 2021 were divided into a control group and an observation group according to different surgical treatment methods, with 30 cases in each group. The control group was treated with open surgery, while the observation group was treated with laparoscopic radical resection. The operation indicators, postoperative recovery indicators, inflammatory factors, gastrointestinal hormone levels, postoperative complications, and one-year survival rate were observed and compared between the two groups. Results There were no significant differences in operation time and number of lymph nodes dissected between the two groups (P>0.05). The intraoperative blood loss volume and incision length of the observation group were less and shorter than those of the control group (P<0.01). The duration of postoperative abdominal distension, anal exhaust time, first feeding time, and hospital stay in the observation group were significantly shorter than those in the control group (P<0.01). There were no significant differences in serum inflammatory factors between the two groups before operation (P>0.05), but the levels of IL-6, IL-8, IL-10 and C-reactive protein (CRP) at postoperative 1, 3 and 7 days in the observation group were significantly better than those in the control group (P<0.01). There were no significant differences in the levels of serum motilin and gastrin between the two groups before operation (P>0.05), but the levels of motilin and gastrin in the observation group were significantly higher than those in the control group after operation (P<0.01). The frequency of postoperative complications in the observation group was significantly lower than that in the control group (P<0.05). After one year of follow-up, the survival rate was 80.0% (24/30) in the observation group and 76.67% (23/30) in the control group, and there was no significant difference between the two groups (P>0.05). Conclusion Compared with traditional open surgery, laparoscopic radical resection has a milder impact on gastrointestinal function, less injury and inflammation, fewer postoperative complications, and faster recovery in CRC patients under the premise of ensuring the surgical treatment effect, which has a high promotion value.

Key words: Laparoscopy, Radical resection, Colorectal cancer, Gastrointestinal hormone, Inflammatory factor, Clinical effect

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