腹腔镜结直肠癌手术对肝功能的影响

Effects of laparoscopic radical resection for colorectal cancer on liver functions

目的探讨腹腔镜结直肠癌手术对肝功能的影响。方法 56例结直肠癌患者分为腹腔镜结直肠癌根治术组(腔镜组,21例)和开腹结直肠癌根治术组(开腹组,35例)。比较两组患者术前及术后第1、3和5天血清AST、ALT、碱性磷酸酶(ALP)和总胆红素(TBil)水平变化。结果两组患者术后第1天的血清AST和ALT均较术前升高(P<0.05)。腔镜组术后第1、3天的血清AST高于开腹组[(67.3±21.2)U/L vs.(40.7±13.8)U/L、(41.6±15.6)U/L vs.(25.2±8.5)U/L](P<0.05);腔镜组术后第1、3天的血清ALT也高于开腹组[(65.9±18.3)U/L vs.(39.7±11.9)U/L、(39.5±15.7)U/L vs.(23.9±7.7)U/L](P<0.05)。两组术后血清ALP和TBil水平与术前和组间比较差异均无统计学意义(P>0.05)。结论腹腔镜结直肠癌手术对患者肝功能会有一定的影响,但其变化轻微、短暂;对没有严重肝脏疾患的患者实施腹腔镜结直肠手术是安全、可行的。

Objective To investigate the effects of laparoscopic radical resection for colorectal cancer on the liver functions.Methods Fifty-six patients with colorectal cancer undergoing radical resection for colorectal cancer were divided into two groups of A（operated by laparoscopy,21cases）and B（operated by traditional open hemicolectomy,35 cases）.Serum aspartate aminotransferase（AST）,alanine aminotransferase（ALT）,alkaline phosphatase（ALP）and total bilirubin（TBil）were measured before and on the 1st,3rd,and 5th day after surgery.The changes of liver functions were analyzed and compared between two groups.Results Serum levels of AST and ALT in both groups were higher on the 1st postoperative day than those before（P〈0.05）.Serum levels of AST on the 1st and 3rd day after operation were higher in group A than those in group B[（67.3±21.2）U/L vs.（40.7±13.8）U/L and（41.6±15.6）U/L vs.（25.2±8.5）U/L]（P〈0.05）.So did those of ALT[（65.9±18.3）U/L vs.（39.7±11.9）U/L and（39.5±15.7）U/L vs.（23.9±7.7）U/L]（P〈0.05）.The abnormalities of AST and ALT returned to normal levels on the 3rd day in group B or on the 5th day in group A.There were no significant differences in serum levels of ALP and TBil between two groups or before and after surgery（P〉0.05）.Conclusion Laparoscopic colorectal cancer surgery has a certain influence on the liver functions,which is transient and slight.Laparoscopic colorectal surgery is safe and feasible in the patients without serious liver diseases.