不同腹腔镜手术入路结直肠癌根治术对结直肠癌患者的影响

Effects of Different Laparoscopic Surgical Approaches Radical Resection of Colorectal Cancer on the Patients with Colorectal Cancer

目的:探讨不同腹腔镜手术入路结直肠癌根治术对结直肠癌患者的影响。方法:选取本院2018年5月-2020年5月所接收和治疗的98例结直肠癌患者作为研究对象,按照随机法将其分试验组和参照组,每组49例。试验组患者采用中间入路腹腔镜结直肠癌根治术治疗,参照组患者采用侧方入路腹腔镜结直肠癌根治术治疗。对比两组患者的手术情况,术后肠胃功能恢复情况,术前及术后1个月血清癌胚抗原(CEA)、糖类抗原19-9(CA199)及外周血T淋巴细胞水平,并发症情况。结果:试验组手术时间、住院时间均短于参照组(P<0.05),术中出血量少于参照组,淋巴清除数目明显多于参照组(P<0.05)。试验组术后1个月CEA、CA199水平均低于参照组(P<0.05)。试验组肠鸣音恢复时间、进食时间及肛门排气时间均早于参照组(P<0.05)。试验组术后1个月CD3^(+)、CD4^(+)、CD8^(+)水平均高于参照组(P<0.05)。试验组并发症发生率明显低于参照组(P<0.05)。结论:较侧方入路腹腔镜结直肠癌根治术而言,中间入路腹腔镜结直肠癌根治术手术耗时较短,且安全性高,并发症发生率低,可以有效改善肿瘤因子水平。

Objective:To explore the effects of different laparoscopic surgical approaches radical resection of colorectal cancer on the patients with colorectal cancer.Method:A total of 98 patients with colorectal cancer received and treated in our hospital from May 2018 to May 2020 were selected as the research objects.Then they were randomly divided into the experimental group and the reference group,with 49 cases in each group.Patients in the experimental group were treated with middle approach laparoscopic radical resection of colorectal cancer treatment,while patients in the control group were treated with lateral approach laparoscopic radical resection of colorectal cancer treatment.The operation situation,postoperative gastrointestinal function recovery,serum carcino embryonic antigen(CEA),carbohydrate antigen 19-9(CA199)and peripheral blood T lymphocyte levels before and 1 month after operation,and complications were compared between the two groups.Result:The operation time and hospital stay of experimental group were shorter than that of reference group(P<0.05),the amount of intraoperative blood loss was less than that of reference group,and the number of lymphatic clearance was significantly more than that of reference group(P<0.05).CEA and CA199 levels 1 month after operation in the experimental group were lower than those in the reference group(P<0.05).The recovery time of bowel sounds,feeding time and anal exhaust time in experimental group were earlier than those in reference group(P<0.05).The levels of CD3^(+),CD4^(+)and CD8^(+)1 month after operation in the experimental group were higher than those in the reference group(P<0.05).The incidence of complications in experimental group was significantly lower than that in reference group(P<0.05).Conclusion:Compared with the lateral approach laparoscopic radical resection of colorectal cancer,the middle approach laparoscopic radical resection of colorectal cancer has shorter time-consuming in operation,with high safety and low complication rate,and can effectively improve the level of tumor factors.