3D腹腔镜下全结肠系膜切除术治疗右半结肠癌的效果观察

Effects of 3D laparoscopic complete mesocolic excision on patients with right colon cancer

目的探讨3D腹腔镜下全结肠系膜切除术(CME)治疗右半结肠癌的效果。方法抽取2017年12月至2018年12月驻马店市中医院收治的84例右半结肠癌患者患者的临床资料,其中45例行3D腹腔镜下CME治疗(观察组),39例行传统开腹CME治疗(对照组)。比较两组患者的围术期指标、手术前后应激反应指标、术后并发症发生情况和术后复发率。结果观察组的手术时间、术中出血量、止痛药物使用时间、肛门排气时间、下床时间和住院时间均短于对照组(P<0.05);术后即刻,两组患者的皮质醇(COR)和肾上腺素(E)水平较术前明显上升(P<0.05),且观察组的COR、E水平低于对照组(P<0.05);观察组患者的并发症发生率(11.11%)低于对照组(30.77%),术后12个月的复发率低于对照组(P<0.05)。结论3D腹腔镜下CME治疗右半结肠癌安全可行,可减少手术创伤,减轻应激反应,降低并发症发生率与复发率,缩短患者恢复时间。

Objective To explore the effects of 3D laparoscopic complete mesocolic excision(CME)on perioperative indexes,immune function and postoperative recurrence rate in patients with right colon cancer.Methods The clinical data of 84 patients with right colon cancer who were admitted and treated in Zhumadian Hospital of Traditional Chinese Medicine between December 2017 and December 2018 were collected.Among the patients,there were 45 cases treated with 3D laparoscopic CME(observation group)and 39 cases treated with traditional open CME(control group).The perioperative indexes,stress response,postoperative complications and postoperative recurrence rates of the two groups were compared.Results The operation time,intraoperative blood loss,use time of analgesics,anal exhaust time,ambulation time and hospital stay of the observation group were shorter than those of the control group(P<0.05).Cortisol(COR)and adrenaline(E)levels in the two groups of patients immediately after operation were significantly higher than those before operation(P<0.05),which were lower in the observation group than those in the control group(P<0.05).The incidence of complications in the observation group(11.11%)was lower than that in the control group(30.77%),and the recurrence rate in 12 months after operation was lower than that in the control group(P<0.05).Conclusions 3D laparoscopic CME is safe and feasible in the treatment of right colon cancer.It can not only reduce surgical trauma and stress response but also reduce the incidence of complications and recurrence rate,and shorten the recovery time of patients.