腹腔镜下全结肠系膜切除术和传统开腹手术治疗结直肠癌的效果对比

Comparison of effects of laparoscopic complete mesocolic excision versus traditional open surgery in treatment of colorectal cancer

目的:比较腹腔镜下全结肠系膜切除术和传统开腹手术治疗结直肠癌的临床效果。方法:抽取2015年8月至2021年1月平煤神马医疗集团总医院收治的结直肠癌患者58例,按随机数字表法分为腹腔镜组(29例)与开腹组(29例)。开腹组采用传统开腹手术治疗,腹腔镜组采用腹腔镜下全结肠系膜切除术。比较两组围术期情况、炎性因子水平、恢复情况、并发症发生率及预后情况。结果:腹腔镜组术中出血量较开腹组少,手术时间较开腹组短( P<0.05),两组淋巴结清扫数目比较,差异未见统计学意义( P>0.05);腹腔镜组住院时间、胃肠功能恢复时间、下床活动时间较开腹组短( P<0.05);术后1 d,腹腔镜组肿瘤坏死因子、C-反应蛋白水平较开腹组低( P<0.05);腹腔镜组并发症发生率(6.90%)与开腹组(13.79%)比较,差异未见统计学意义( P>0.05);腹腔镜组复发率(3.57%)、术后肿瘤致死率(10.71%)、远处转移率(10.71%)与开腹组(3.70%、14.81%、14.81%)比较,差异未见统计学意义( P>0.05)。 结论:与传统开腹手术比较,采用腹腔镜下全结肠系膜切除术治疗结直肠癌有利于改善围术期情况,并可改善远期预后,促进患者术后尽快恢复,缓解炎性应激,手术具有安全性。

Objective To compare the chinical effect of laparoscopic complete mesocolic excision and traditional open surgery in the treatment of colorectal cancer.Methods A total of 58 patients with colorectal cancer in General Hospital of Pingmei Shenma Medical Group from August 2015 to January 2021 were selected,and divided into laparoscopic group(29 cases)and open surgery group(29 cases)according to the random number table method.The open surgery group was treated with traditional open surgery,and the laparoscopic group was treated with laparoscopic complete mesocolic excision.The perioperative situation,inflammatory factor levels,recovery,complication rate and prognosis were compared between the two groups.Results The amount of intraoperative bleeding in the laparoscopic group was less than that in the open surgery group,and the operation time was shorter than that in the open surgery group(P<0.05),the number of lymph node dissections was no significant between the two groups(P>0.05).The length of hospital stays,gastrointestinal function recovery time and the time for ambulation in the laparoscopic group were shorter than those in the open surgery group(P<0.05).One day after surgery,the levels of tumor necrosis factor-αand C-reactive protein in the laparoscopic group were lower than those in the open surgery group(P<0.05).The incidence of complications in the laparoscopic group(6.90%)was compared with that in the open surgery group(13.79%),There was no significant(P>0.05).The recurrence rate(3.57%),postoperative mortality rate(10.71%)and distant metastasis rate(10.71%)in the laparoscopic group were compared with those in open surgery group(3.70%,14.81%and 14.81%),there was no significant(P>0.05).Conclusions Compared with traditional laparotomy,laparoscopic complete mesocolic excision for colorectal cancer can improve the perioperative situation,improve the long-term prognosis,promote postoperative recovery,relieve inflammatory stress,and is safe.