腹腔镜根治术对直肠癌患者肛肠动力学和血清血管内皮生长因子C水平的影响

Effects of laparoscopic radical operation on anorectal dynamics and serum levels of vascular endothelial growth factor C in patients with colorectal cancer

目的探讨腹腔镜根治术对直肠癌患者肛肠动力学、血清血管内皮生长因子C(VEGF-C)水平的影响。方法选取确诊治疗的直肠癌患者100例,依据随机分配原则分为腹腔组和开腹组,每组50例。开腹组患者给予开腹根治术治疗,腹腔组患者给予腹腔镜根治术治疗,分析患者治疗疗效、术前术后肛肠动力学、血清VEGF-C水平。结果腹腔组患者术中出血量、排气、住院时间、并发症发生率明显低于开腹组,腹腔组手术时间明显高于开腹组,差异有统计学意义(P<0.05),但2组患者1年内复发转移率、病死率差异无统计学意义(P>0.05);腹腔组和开腹组患者术后肛管高压区长度(HPZ)、静息压(ARP)、最大收缩压(MSP)和3、7 d血清VEGF-C水平明显低于术前,但腹腔组术后HPZ、ARP、MSP水平明显高于开腹组,腹腔组术后3、7 d血清VEGF-C水平明显低于开腹组,差异有统计学意义(P<0.05)。结论腹腔镜根治术可有效减少直肠癌患者术中创伤、术后并发症发生,有利于患者术后肛肠动力恢复,且无增加复发转移、死亡等发生的风险,但仍需提高相关操作技术。

Objective To observe the effects of laparoscopic radical operation on anorectal dynamics and serum levels of vascular endothelial growth factor C(VEGF-C)in patients with colorectal cancer.Methods One hundred patients with colorectal cancer who were admitted and treated in our hospital from December 2011 to December 2015 were randomly divided into open abdomen group and laparoscope group,with 50 patients in each group.The patients in open abdomen group were treated by open abdomen radical operation,however,the patients in laparoscope group were treated by laparoscopic radical operation.The curative effects,the changes of anorectal dynamics,serum levels of VEGF-C before and after operation were statistically analyzed and compared between two groups.Results The intraoperative bleeding volume,exhaust time,hospitalization time,incidence rate of complication in laparoscope group were significantly lower than those in open abdomen group(P<0.05),however,the operation time in the former was significantly longer than that in the latter(P<0.05),moreover,there were no significant differences in 1-year relapse rate and fatality rate between two groups(P>0.05).The anal canal high pressure zone length(HPZ),anal rest pressure(ARP),maximal squeezing pressure(MSP)and serum levels of VEGF-C on 3d,7d after operation were significantly decreased in both groups,as compared with those before operation,moreover,after operation the levels of HPZ,ARP,MSP in laparoscope group were significantly higher than those in open abdomen group,however,the serum levels of VEGF-C on 3d,7d after operation were significantly lower than those in open abdomen group(P<0.05).Conclusion The laparoscopic radical operation can effectively reduce the intraoperative trauma of patients with rectal cancer,decrease postoperative complications,which is beneficial to anorectal dynamic recovery,without increaing the risks of relapse,metastasis,death occurrence,but it is required to improve the relevant operation technique.