腹腔镜下右半结肠癌根治术与开腹手术对胃肠功能的影响

A study on the gastrointestinal function affected by laparoscopic radical right colon cancer operation and laparotomy

目的探讨腹腔镜下右半结肠癌根治术与开腹手术对胃肠功能的影响。方法采用回顾性、随机抽样研究方法,2012年7月至2017年5月选择在本院诊治的右半结肠癌患者92例作为研究对象,按照手术方法的不同把患者分为研究组与对照组各46例。研究组采用腹腔镜下右半结肠癌根治术,对照组采用传统开腹手术治疗,记录2组预后及其对胃肠功能的影响。结果两组术中出血量、手术时间对比无显著差异,研究组的术后排便时间、排气时间、肠鸣音恢复时间都显著少于对照组(P<0.05)。研究组术后14d的吻合口出血、腹腔脓肿、肺部感染、吻合口漏、切口感染发生率为6.5%,对照组为19.6%,研究组显著少于对照组(P<0.05)。术后14d两组的血清胃泌素(GS)含量都显著高于术前(P<0.05),术后14d研究组的血清GS含量也显著高于对照组(P<0.05)。结论腹腔镜下右半结肠癌根治术具有很好的可行性与安全性,能减轻对于患者的创伤,促进胃肠动力恢复,促进胃泌素的分泌,减少并发症的发生。

Objective To investigate the effects of laparoscopic radical right colon cancer operation and laparotomy on gastrointestinal function.Methods In the retrospective control study,92 cases of right colon cancer treated during July 2012 and May 2017 were randomly sampled and divided into two groups according to the surgical methods:the study group(n=46,treated with laparoscopic radical right colon cancer operation)and the control group(n=46,treated with traditional laparotomy).The prognosis and gastrointestinal function of the two groups were recorded.Results There were no significant differences in the operation time and bleeding volume between the two groups.The postoperative defecation time,exhaust time,and bowel sound recovery time were significantly shorter in the study group than in the control group(P<0.05).Fourteen days after operation,the incidence of complications such as incision infection,anastomotic leakage,pulmonary infection,abdominal abscess and anastomotic bleeding was 6.5%in the study group,and 19.6%in the control group(P<0.05).The level of serum gastrin(GS)increased in both groups(P<0.05),and the GS level was higher in the study group than in the control group(P<0.05).Conclusion The laparoscopic radical right colon cancer operation is safe and effective.It can reduce trauma to patients,improve the secretion of gastrin,promote gastrointestinal motility recovery and reduce complications.