腹腔镜与开腹直肠癌根治术对老年患者机体炎症影响的比较

Effect of laparoscopic and open radical resection of rectal carcinoma on inflammatory cytokines in elderly patients

目的:比较腹腔镜与开腹直肠癌根治术对老年患者机体炎症的影响。方法:选择行腹腔镜直肠癌根治术的老年患者40例设为腹腔镜组,选择同期行开腹直肠癌根治术的老年患者40例设为开腹组。比较两组患者的围术期情况、手术前后炎症因子水平和并发症发生情况。结果:腹腔镜组患者的手术时间、术中失血量、肠道排气时间和住院时间均明显少于开腹组(P<0.01);腹腔镜组患者术后1、3d的血清CRP和IL-6等炎症因子水平明显低于开腹组,而TNF-α水平明显高于开腹组,两组比较,差异均有统计学意义(P<0.01或P<0.05);腹腔镜组患者术后并发症发生率明显低于开腹组(P<0.05)。结论:相对开腹直肠癌根治术而言,腹腔镜直肠癌根治术对老年患者组织损伤较小,炎症反应更弱,术后恢复更快。

Objective：To investigate the impact of laparoscopic and open radical resection of rectal carcinoma on inflam-matory cytokines in elderly patients.Methods：40 cases of elderly patients with rectal carcinoma scheduled for la-paroscopy acted as laparoscopic group,and another 40 cases referred to open surgery as open group.A comparison was un-dertaken in terms of the perioperative status,pre-and post-operative levels of the inflammatory cytokines and complica-tion incidence.Results：The duration of surgery,intra-operative blood loss,time for anal exsufflation and hospital stay were markedly less in the laparoscopic group than in the control group（all P〈0.01）;the serum levels of CRP and IL-6 1 and 3 days after surgery were considerably lower in the laparoscopic group than those in the control group,while the level of TNF-alpha was increased,with significant differences between two groups（P〈0.01 or P〈0.05）;and the incidence rate for complication was much lower（P〈0.05）.Conclusion：Compared with open surgery,the laparoscopic-assisted radical resec-tion of rectal carcinoma may have less tissue injury,weaker inflammatory reaction and more rapidly postoperative recovery.