腹腔镜直肠癌根治术治疗早期直肠癌的效果及其对患者生存期的影响

The Effect of Laparoscopic Radical Resection of Rectal Cancer in the Treatment of Early Rectal Cancer and Its Impact on Patient Survival

目的探讨腹腔镜直肠癌根治术治疗对早期直肠癌患者生存期及血清PGE2、VEGF、COLⅣ表达的影响。方法纳入2014年5月~2015年6月收治的71例早期直肠癌患者,按照手术方式不同分为观察组37例,对照组34例。对照组行开腹直肠癌根治术治疗,观察组行腹腔镜直肠癌根治术治疗,比较两组术中及术后指标,血清PGE2、VEGF、COLⅣ表达含量、术后并发症及3、5年生存率。结果观察组术中出血量、住院时间均少于对照组(P<0.05);两组手术时间、淋巴结清扫数目比较,差异无统计学意义(P>0.05);术后1周,两组血清PGE2、VEGF、COLⅣ表达含量均较术前降低,且观察组均低于对照组(P<0.05);观察组术后并发症总发生率为8.11%,低于对照组的26.47%(P<0.05);观察组3年生存率为91.89%,5年生存率为86.49%,分别对照组的91.18%、85.29%比较,差异无统计学意义(P>0.05)。结论腹腔镜直肠癌根治术治疗早期直肠癌3年、5年生存率与开腹手术相当,对患者创伤小、术后并发症少、康复快,有助于改善术后短期内血清PGE2、VEGF、COLⅣ指标,减少肿瘤负荷,改善预后。

Objective To investigate the effect of laparoscopic radical resection of rectal cancer on the survival of patients with early rectal cancer and the expression of serum PGE2,VEGF and COLIV.Methods A total of 71 patients with early rectal cancer admitted from May 2014 to June 2015 were enrolled.According to different surgical methods,they were divided into 37 cases in the observation group and 34 cases in the control group.The control group was treated with open radical rectal cancer,and the observation group was treated with laparoscopic radical rectal cancer.The intraoperative and postoperative indicators of the two groups were compared,the serum PGE2,VEGF,COLIV expression levels,postoperative complications,and 3,5 years survival rate.Results The intraoperative blood loss and hospital stay in the observation group were less than those in the control group(P<0.05);There was no significant difference in the operation time and the number of lymph node dissections between the two groups(P>0.05);1 week after operation,the serum PGE2,VEGF,and COLⅣexpression levels in the two groups were lower than those before the operation,and the observation group was lower than the control group(P<0.05);The total incidence of postoperative complications in the observation group was 8.11%,which was lower than 26.47%in the control group(P<0.05);the observation group had a 3-year survival rate of 91.89%and a 5-year survival rate of 86.49.Compared with 91.18%and 85.29%of the control group,the difference was not statistically significant(P>0.05).Conclusion Laparoscopic radical rectal cancer treatment for early rectal cancer has a 3-year and 5-year survival rate equivalent to that of open surgery,with less trauma,fewer postoperative complications,and faster recovery.It helps to improve the serum PGE2,VEGF,COLIV indicators in the short term after operation.