腹腔镜D3根治术对低位梗阻性左半结直肠癌患者临床预后的影响研究

Effect of Laparoscopic D3 Radical Resection on the Prognosis of Patients with Low Obstructive Left Colorectal Cancer

目的探讨腹腔镜D3根治术对低位梗阻性左半结直肠癌患者临床预后的影响研究。方法回顾性分析102例低位梗阻性左半结直肠癌患者,根据手术方法不同将其分为观察组(n=51)与对照组(n=51),观察组行腹腔镜D3根治术,对照组行开腹结直肠癌根治术。对比两组患者手术相关指标、胃动素及胃泌素水平、T淋巴细胞亚群水平、胃肠功能恢复情况及并发症发生率。结果观察组时间高于对照组,而观察组术中出血量、住院时间及淋巴结清扫数目低于对照组(P<0.05);术后3 d,观察组胃动素及胃泌素水平低于对照组(P<0.05);观察组CD3+、CD4+、CD8+均高于对照组(P<0.05);观察组肠鸣音恢复时间、排气时间、排便时间及开始进食时间均优于对照组(P>0.05);观察组并发症发生率明显低于对照组(5.88%vs19.61%)(P>0.05)。结论腹腔镜D3根治术对低位梗阻性左半结直肠癌患者能够有效减少术中出血量,促进胃肠功能恢复,改善T淋巴细胞亚群、胃动素和胃泌素水平,降低并发症发生率,值得在临床上推广及应用。

Objective To study the effect of laparoscopic D3 radical surgery on the prognosis of patients with low obstructive left colorectal cancer.Methods A retrospective analysis was performed on 102 patients with low obstructed left half colorectal cancer,who were divided into the observation group(n=51)and the control group(n=51)according to different surgical methods.The observation group received laparoscopic D3 radical resection,while the control group received open radical resection of colorectal cancer.Operative indicators,motilin and gastrin levels,T lymphocyte subsets,gastrointestinal function recovery and complication rates were compared between the two groups.Results The duration of the observation group was higher than that of the control group,while the amount of intraoperative blood loss,length of hospital stay and number of lymph node dissection in the observation group were lower than those in the control group(P<0.05).The levels of motilin and gastrin in the observation group were lower than those in the control group(P<0.05).CD3+,CD4+and CD8+in the observation group were all higher than those in the control group(P<0.05).The recovery time of bowel sounds,exhaust time,defecation time and feeding time of the observation group were all better than those of the control group(P>0.05).The incidence of complications in the observation group was significantly lower than that in the control group(5.88%vs19.61%)(P>0.05).Conclusion Laparoscopic D3 radical surgery for patients with low obstructive left colorectal cancer can effectively reduce intraoperative blood loss,promote gastrointestinal function recovery,improve T lymphocyte subsets,motility and gastrin levels,and reduce the incidence of complications,which is worthy of clinical promotion and application.