腹腔镜下结直肠癌根治术对高龄结直肠癌患者胃肠功能的影响

Effect of laparoscopic radical resection of colorectal cancer on gastric function in senile patients with colorectal cancer

目的:探求高龄结直肠癌患者采用腹腔镜下结直肠癌根治术治疗对其胃功能的影响。方法:选择某院择期行手术治疗的高龄结直肠癌患者98例,随机分为对照组和观察组,每组各49例。对照组采用开腹手术治疗,观察组采用腹腔镜下结直肠癌根治术治疗,随访1个月,比较2组手术相关指标、胃肠功能恢复情况、胃泌素、胃动素水平及并发症发生率。结果:相较于对照组,观察组术中失血量较少,手术时间、术后住院时间、术后首次排气时间、肠鸣音恢复时间、进食时间较短,并发症发生率较低,差异有统计学意义(P <0. 05);观察组术后24 h,72 h胃泌素、胃动素水平均较对照组高,且2组术后72 h胃泌素、胃动素水平均较术后24 h高,差异有统计学意义(P <0. 05); 2组淋巴结清除数目比较,差异无统计学意义(P> 0. 05)。结论:腹腔镜下结直肠癌根治术可获取与开腹手术相同疗效,利于减轻高龄患者机体创伤性,通过提高胃泌素、胃动素水平促进其术后胃肠功能恢复,且并发症少。

Objective：To investigate the effect of laparoseopie radical resection of eoloreetal cancer on gastric function in senile patients with colorectal cancer. Methods ：98 senile colorectal cancer patients were selected and randomly divided into a control group and an observation group ,49 cases in each. The control group underwent laparotomy, while the observation group was treated with laparoscopic radical resection of eoloreetal cancer. After one-month follow-up, the surgical indexes as well as the recovery- of gastrointestinal function, gastrin, motilin, and complications were compared between the two groups. Results ： Compared with the control group, the intraoperative bleeding volume of the observation group was less ; the operation time, postoperative hospital stays, postoperative first exhaust time, recovery time of bowel sound, and time of taking food in the observation group were shorter; the incidence of complications was lower（ P 〈 0.05 ）. The postoperative 24h and 72h gastrin and motilin levels in the observation group were higher than those in the control group, and the postoperative 72h gastrin and motilin levels in the two groups were higher than the postoperative 24h levels （ P 〈 0.05 ）. There was no statistical difference in the number of lymph node dissection between the two groups （ P 〉 0.05 ）. Conclusion ： Laparoscopic radical resection of colorectal cancer in treatment of senile patients with colorectal cancer is of the same efficacy as laparotomy. It can reduce trauma, increase gastrin and motilin levels, enhance postoperative recovery of gastrointestinal function, induce less complications and promote patients＇ early recovery.