以肠系膜上动脉为导向的腹腔镜下右半结肠全结肠系膜切除术治疗右半结肠癌的临床效果

Clinical effect of laparoscopic complete mesocolic excision of right colon guided by superior mesenteric artery in the treatment of right colon cancer

目的探讨以肠系膜上动脉为导向的腹腔镜下右半结肠全结肠系膜切除术治疗右半结肠癌的临床效果。方法选取2016年1月至2019年12月收治的110例右半结肠癌患者作为研究对象,将其随机分为观察组和对照组,各55例。观察组采用以肠系膜上动脉为导向的腹腔镜下右半结肠全结肠系膜切除术治疗,对照组采用以肠系膜上静脉为导向的腹腔镜下右半结肠全结肠系膜切除术治疗,比较两组的治疗效果。结果观察组手术时间、住院时间短于对照组,术中出血量少于对照组(P<0.05)。术后,观察组Th1细胞水平高于对照组,Th2细胞水平低于对照组(P<0.05)。术后,观察组MIF、VEGF、HMGB1、Ang-2、Tie-2水平低于对照组(P<0.05)。结论以肠系膜上动脉为导向的腹腔镜下右半结肠全结肠系膜切除术治疗右半结肠癌效果显著,能够缩短手术时间,减少术中出血量,促进术后快速康复,改善免疫功能,降低MIF、VEGF、HMGB1、Ang-2、Tie-2水平。

Objective To investigate the clinical effect of laparoscopic complete mesocolic excision of right colon guided by superior mesenteric artery in the treatment of right colon cancer.Methods A total of 110 patients with right colon cancer who were admitted from January 2016 to December 2019 were selected as the study object and randomly divided into observation group and control group,with 55 cases in each group.The observation group was treated by laparoscopic complete mesocolic excision of right colon guided by superior mesenteric artery,while the control group was treated by laparoscopic complete mesocolic excision of right colon guided by superior mesenteric vein,and the therapeutic effects of the two groups were compared.Results The operation time and hospital stay in the observation group were shorter than those in the control group,and the intraoperative blood loss volume was less than that in the control group(P<0.05).After operation,the Th1 cell level in the observation group was higher than that in the control group,and the Th2 cell level was lower than that in the control group(P<0.05).After operation,the levels of MIF,VEGF,HMGB1,Ang-2 and Tie-2 in the observation group were lower than those in the control group(P<0.05).Conclusion Laparoscopic complete mesocolic excision of right colon guided by superior mesenteric artery in the treatment of right colon cancer has significant effect,which can shorten the operation time,reduce the intraoperative blood loss volume,promote the rapid recovery after operation,improve the immune function and reduce the levels of MIF,VEGF,HMGB1,Ang-2 and Tie-2.