腹腔镜结直肠癌根治术治疗老年结直肠癌安全性及其对应激和炎症反应影响

Safety of laparoscopic radical resection of colorectal cancer and the regulation mechanism of stress and inflammation in elderly patients with colorectal cancer

目的探讨腹腔镜结直肠癌根治术治疗老年结直肠癌(CRC)的安全性及其对炎性因子、应激指标水平的影响。方法选取商丘市第一人民医院2017-01-13-2021-09-21收治的147例老年CRC患者为研究对象,依据手术方案不同分为传统组和腹腔镜组。传统组73例予传统开腹手术治疗,腹腔镜组74例予腹腔镜下CRC根治术治疗。对比2组患者胃肠功能、应激和炎症反应、术后并发症。结果腹腔镜组患者术后1周末胆囊收缩素(CCK)水平为(8.63±1.21)pg/mL,高于传统组的(6.54±1.02)pg/mL,t=11.315,P<0.001;胃泌素(GAS)水平为(213.54±40.08)pg/mL,高于传统组的(175.39±32.64)pg/mL,t=6.323,P<0.001。腹腔镜组术后1周末皮质醇(CS)水平为(109.54±15.47)pg/L,低于传统组的(120.62±22.16)pg/L,F=193.510,P<0.001;超敏C反应蛋白(hs-CRP)水平为(22.53±3.32)mg/L,低于传统组的(40.37±5.16)mg/L,F=444.012,P<0.001;肿瘤坏死因子α(TNF-α)水平为(52.43±10.15)ng/L,低于传统组的(67.29±12.53)ng/L,F=8344.549,P<0.001。腹腔镜组术后并发症发生率为2.70%(2/74),低于传统组的5.48%(4/73),差异无统计学意义,P=0.442。结论腹腔镜下CRC根治术治疗老年CRC患者,可调节应激、炎症反应,改善胃肠功能,有较高安全性。

Objective To explore the safety and effects of laparoscopic radical resection of colorectal cancer on inflammatory factors and stress indicators in elderly patients with colorectal cancer(CRC).Methods A total of 147 elderly CRC patients in Shangqiu First People’s Hospital from January 13,2017 to September 21,2021 were selected as the research objects and divided into traditional group and laparoscopic group according to different surgical plans.Seventy-three patients in the traditional group were treated with traditional open surgery,and 74 patients in the laparoscopic group were treated with laparoscopic radical resection of colorectal cancer.Gastrointestinal function,stress,inflammatory reaction and postoperative complications were compared between the two groups.Results The level of cholecystokinin(CCK)in the laparoscopic group was(8.63±1.21)pg/ml,which was higher than that in the traditional group(6.54±1.02)pg/ml,t=11.315,P<0.001;Gastrin(GAS)level was(213.54±40.08)pg/ml,which was higher than that of traditional group(175.39±32.64)pg/ml,t=6.323,P<0.001.The level of cortisol(CS)in the laparoscopic group was(109.54±15.47)pg/L,which was lower than that in the traditional group(120.62±22.16)pg/L,F=193.510,P<0.001;The level of high-sensitivity C-reactive protein(hs-CRP)was(22.53±3.32)mg/L,which was lower than that of the traditional group(40.37±5.16)mg/L,F=444.012,P<0.001;The level of tumor necrosis factor-α(TNF-α)was(52.43±10.15)ng/L,which was lower than that of the traditional group(67.29±12.53)ng/L,F=8344.549,P<0.001.The incidence of postoperative complications in the laparoscopic group was 2.70%(2/74),which was lower than that in the traditional group[5.48%(4/73)],and the difference was not statistically significant(P=0.442).Conclusion Laparoscopic radical resection of colorectal cancer in elderly CRC patients can regulate stress and inflammatory response,improve gastrointestinal function,and has high safety.