腹腔镜和开腹根治手术治疗左半结肠癌患者的效果比较

Comparison of effects of laparoscopic and open radical surgery on patients with left colon cancer

目的:比较腹腔镜和开腹根治手术治疗左半结肠癌患者的效果。方法:选取62例左半结肠癌患者为研究对象,按照随机数字表法分为观察组和对照组各31例。对照组采用开腹结肠癌根治术治疗,观察组采用腹腔镜结肠癌根治术治疗。比较两组围术期指标水平、炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及C反应蛋白(CRP)]水平、肠道菌群数量及并发症发生率。结果:观察组手术时间长于对照组,术中出血量少于对照组,术后肠鸣音恢复时间和住院时间均短于对照组,术后并发症发生率及TNF-α、IL-6、CRP水平均低于对照组,差异有统计学意义(P<0.05);术后7 d,两组大肠埃希菌、肠球菌数量均高于术前,但观察组低于对照组;两组乳酸菌、双歧杆菌数量均低于术前,但观察组高于对照组,差异有统计学意义(P<0.05)。结论:与开腹手术相比,腹腔镜手术治疗左半结肠癌患者效果显著,可减少术中出血量,缩短术后肠鸣音恢复时间和住院时间,降低炎性因子水平和并发症发生率,还能改善肠道微生态环境。

Objective:To compare effects of laparoscopic and open radical surgery on patients with left colon cancer.Methods:62 patients with left colon cancer were selected as the research objects and were divided into observation group and control group according to the random number table method,31 cases in each.The control group was treated with radical surgery of colon cancer,while the observation group was treated with laparoscopic radical surgery.The perioperative indicator levels,the inflammatory factor levels[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP)],the number of intestinal flora and the incidence of complications were compared between the two groups.Results:The operation time of the observation group was longer than that of the control group;the intraoperative blood loss was less than that of the control group;the postoperative bowel sounds recovery time and the hospitalization time were shorter than those of the control group;the incidence of postoperative complications and the levels of TNF-α,IL-6 and CRP were lower than the control group;and the differences were statistically significant(P<0.05).7 days after the surgery,the numbers of Escherichia coli and Enterococcus in the two groups were higher than those before the surgery,but those of the observation group were lower than those of the control group;the numbers of lactic acid bacteria and Bifidobacteria in the two groups were lower than those before the surgery,but those of the observation group were higher than those of the control group;and the differences were statistically significant(P<0.05).Conclusions:Compared with the open surgery,the laparoscopic surgery has a significant effect in the treatment of the patients with left colon cancer,which can reduce the intraoperative blood loss,shorten the postoperative bowel sound recovery time and the hospitalization time,reduce the levels of inflammatory factors and the incidence of complications.Moreover,it can improve the intestinal microecological environment.