手助腹腔镜在直肠癌治疗中的应用及对血清肿瘤标志物的影响

Application of hand assisted laparoscopic surgery in the treatment of rectal cancer and its influence on serum tumor markers

目的探讨手助腹腔镜在直肠癌中的应用效果及对血清肿瘤标志物的影响。方法选取2016年1月至12月我院收治的62例直肠癌患者作为研究对象,根据手术方式将研究对象分为手助腹腔镜组33例和开腹手术组29例,观察2组术中失血量、手术切口长度、术后下床活动时间、术后肠功能恢复时间、术后住院时间、清扫淋巴结数目,分别于术前及术后3d测定血清癌胚抗原(CEA)、糖链抗原(CA)19-9、CA242含量。结果手助腹腔镜组的术中失血量、手术切口长度、术后下床活动时间、术后肠功能恢复时间、术后住院时间均低于开腹手术组,差异有统计学意义(P<0.05);手助腹腔镜组与开腹手术组的清扫淋巴结数目差异无统计学意义(P>0.05)。术前2组患者CEA、CA19-9、CA242含量差异无统计学意义(P>0.05);术后3d手助腹腔镜组的CEA、CA19-9、CA242含量低于术前,开腹手术组的CA19-9、CA242含量低于术前,手助腹腔镜组的CEA、CA19-9、CA242含量低于开腹手术组,差异有统计学意义(P<0.05)。结论手助腹腔镜对直肠癌患者的创伤轻,有利于患者的术后恢复及血清肿瘤标志物的清除。

Objective To investigate the effect of hand assisted laparoscopic surgery in rectal cancer and its influence on serum tumor markers. Methods Sixty two patients with rectal cancer admitted in our hospital from January 2016 to December 2016 were selected as the subjects, and they were divided into two groups： hand assis- ted laparoscopic surgery group （n= 33） and laparotomy group （n= 29）. We observed two groups＂ intraoperative blood loss, incision length, postoperative ambulation time, postoperative intestinal function recovery time, post- operative hospitalization time, the number of lymph nodes. The levels of serum CEA, CA19-9 and CA242 were measured before and 3 days after operation. Results Hand assisted laparoscopic group＇s intraoperative blood loss, incision length, postoperative ambulation time, postoperative intestinal function recovery time, postoperative hos- pitalization time were lower than that of the laparotomy group, the difference was statistically significant （P〈 0.05） ; There was no significant difference in the number of lymph nodes between the laparoscopic group and the laparotomy group （P〉0. 05）. Before operation, there was no significant difference in CEA, CA19-9 and CA242 between the two groups （P〉0.05） ; 3 days after operation, the contents of CEA, CA19-9 and CA242 in hand as- sisted laparoscopic surgery group were lower than those before operation. The content of CA19-9 and CA242 in laparotomy group was lower than that before operation. The contents of CEA, CA19-9 and CA242 in hand assis- ted laparoscopic surgery group were lower than those in laparotomy group, the difference was statistically signifi- cant （P〈0. 05）. Conclusion Hand assisted laparoscopic surgery is a minimally invasive procedure for patients with rectal cancer, which is beneficial to the recovery of patients and the clearance of serum tumor markers.