腹腔镜手术与开腹手术治疗中晚期结直肠癌的临床疗效

Clinical Effect of Laparoscopic Surgery and Open Surgery in the Treatment of Advanced Colorectal Cancer

目的比较腹腔镜手术与开腹手术在中晚期结直肠癌患者中的效果。方法选取2020年2月—2021年2月收治的94例中晚期结直肠癌患者,按随机数字表法分为两组,各47例。对照组采用传统开腹手术,观察组则施行腹腔镜手术,观察至术后3个月。对比两组手术相关指标、术后恢复情况、炎性因子水平、免疫功能(T淋巴细胞)、并发症。结果观察组术中出血量较对照组少,切口长度、手术、肛门排气、创面愈合、下床活动、住院时间较对照组短,差异有统计学意义(P<0.05);术前,两组白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)相比,差异无统计学意义(P>0.05);观察组术后1周IL-6、TNF-α、CRP、CD8^(+)较对照组低,CD4^(+)、CD4^(+)/CD8^(+)较对照组高,差异有统计学意义(P<0.05);观察组并发症发生率为6.38%,较对照组的21.28%低,差异有统计学意义(χ^(2)=4.374,P=0.037)。结论相较于开腹手术,腹腔镜手术在中晚期结直肠癌患者治疗中具有术中出血量低、手术时间短、对免疫功能影响小、术后并发症少等特点,可明显控制机体炎性反应,促进术后更快恢复,安全可行,应用价值较高。

Objective To compare the effects of laparoscopic surgery and open surgery in patients with advanced colorectal cancer.Methods A total of 94 patients with advanced colorectal cancer who were admitted from February 2020 to February 2021 were selected and divided into two groups according to the random number table method,with 47 cases in each group.The control group underwent traditional laparotomy,and the observation group underwent laparoscopic surgery,and the observation was performed until 3 months after the operation.The operation-related indicators,postoperative recovery,inflammatory factor levels,immune function(T lymphocyte),and complications were compared between the two groups.Results The intraoperative blood loss of the observation group was less than that of the control group,and the incision length,operation,anus exhaust,wound healing,getting out of bed,and hospital stay were shorter than those of the control group,the difference was statistically significant(P<0.05).Before surgery,there was no statistical difference between the two groups of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),the difference was not statistically significant(P>0.05).The IL-6,TNF-α,CRP,and CD8^(+)in the observation group were lower than those in the control group at 1 week after operation,and the CD4^(+)and CD4^(+)/CD8^(+)were higher than those in the control group,the difference was statistically significant(P<0.05).The complication rate in the observation group was 6.38%,which was lower than the 21.28% in the control group,the difference was statistically significant(χ^(2)=4.374,P=0.037).Conclusion Compared with open surgery,laparoscopic surgery has the characteristics of low intraoperative blood loss,short operation time,less impact on immune function,and fewer postoperative complications in the treatment of patients with advanced colorectal cancer.It can obviously control the body’s inflammatory reaction,promote faster recovery after surgery,is safe and feasible,and has high application value.