腹腔镜下完整全结肠系膜切除治疗右半结肠癌的疗效观察

Observation of the Curative Effect of Complete Mesocolonectomy Under Laparoscopic Treatment for Cancer of the Right Colon

目的:分析不同术式治疗右半结肠癌的预后效果,评价腹腔镜下完整全结肠系膜切除(Complete Mesocolic Excision,CME)治疗优势。方法:选择2019年3月~2020年1月本院诊治的80例右半结肠癌疾病患者,进行1:1比例法分组手术治疗,即对照组与观察组。观察组(n=40)行腹腔镜下CME治疗,对照组(n=40)行开腹CME治疗。比较两组右半结肠癌患者的治疗情况,包括术中出血量、术后恢复时间、炎症因子水平以及术后并发症、随访6个月复发情况。结果:术中出血量、排气时间、下床时间、住院时间方面,相较于对照组,采取腹腔镜下CME治疗的观察组患者术中出血量少、术后恢复时间短,P<0.05;术后白细胞介素-6(Interleukin 6,IL-6)、白细胞介素-8(Interleukin 8,IL-8)水平比较,采取腹腔镜下CME治疗的观察组炎症水平均明显低于对照组,P<0.05;组间感染、术后出血、肠梗阻、尿潴留、吻合口瘘等并发症情况比较,采取腹腔镜下CME治疗的观察组发生率5.00%明显低于对照组的22.50%,P<0.05;组间随访复发情况比较,观察组2.50%与对照组并无显著差异,P>0.05。结论:腹腔镜下CME可减少右半结肠癌患者手术创伤、应激反应,提高患者安全性,助于患者术后康复。

Objective:To analyze the prognostic effects of different surgical treatments for right colon cancer,and to evaluate the advantages of laparoscopic complete mesocolic excision(CME).Methods:80 patients with right colon cancer who were diagnosed and treated in our hospital from March 2019 to January 2020 were selected for surgical treatment in groups of 1:1 ratio,namely the control group and the observation group.The observation group(n=40)underwent laparoscopic CME treatment,and the control group(n=40)underwent open CME treatment.The treatment of patients with right colon cancer was compared between the two groups,including intraoperative blood loss,postoperative recovery time,inflammatory factor levels,postoperative complications,and 6-month follow-up recurrence.Results:In terms of intraoperative blood loss,exhaust time,time to get out of bed,and hospital stay,compared with the control group,the observation group who took laparoscopic CME treatment had less intraoperative blood loss and shorter postoperative recovery time,P<0.05;Postoperative interleukin-6(interleukin 6,IL-6)and interleukin-8(interleukin 8,IL-8)levels were compared,the level of inflammation in the observation group treated with laparoscopic CME was significantly lower than that in the control group,P<0.05;Comparing the complications of infection,postoperative bleeding,intestinal obstruction,urinary retention,and anastomotic leakage among groups,the incidence of 5.00%in the observation group treated with laparoscopic CME was significantly lower than 22.50%in the control group.P<0.05;In the follow-up comparison between the groups,there was no significant difference between the observation group and the control group(2.50%),P>0.05.Conclusion:CME under laparoscopic surgery can reduce surgical trauma and stress response in patients with right colon cancer,improve patient safety,and help patients recover after surgery.