腹腔镜结肠癌切除+完整结肠系膜切除在老年结肠癌患者中的应用效果

Application effect of laparoscopic resection of colon cancer+complete mesocolon resection in elderly patients with colon cancer

目的探究腹腔镜结肠癌切除+完整结肠系膜切除在老年结肠癌中的应用效果。方法选取本院2016年1月至2020年12月收治的80例老年结肠癌患者为本次研究对象,遵循随机数字法将其分为对照组(n=40)和研究组(n=40)。对照组开展结肠癌根治术治疗,研究组开展腹腔镜结肠癌切除+完整结肠系膜切除治疗。比较两组的治疗效果。结果研究组的术中出血量少于对照组,淋巴结清扫数目多于对照组,差异具有统计学意义(P<0.05)。研究组的术后并发症总发生率为7.50%,低于对照组的40.00%,差异具有统计学意义(P<0.05)。术后3 d,研究组的CD4+、CD4+/CD8+高于对照组,CD8+低于对照组,差异具有统计学意义(P<0.05)。术后3 d,两组的双歧杆菌、屎肠球菌、乳酸杆菌计数均减少,酵母菌、大肠杆菌计数均增多,但研究组双歧杆菌、屎肠球菌、乳酸杆菌计数多于对照组,酵母菌、大肠杆菌计数少于对照组,差异具有统计学意义(P<0.05)。结论腹腔镜结肠癌切除+完整结肠系膜切除可有效改善老年结肠癌患者的手术相关指标、术后免疫功能指标及肠道菌群状况,并降低并发症发生率。

Objective To explore the application effect of laparoscopic resection of colon cancer+complete mesocolon resection in elderly patients with colon cancer.Methods Eighty elderly patients with colon cancer admitted in our hospital from January 2016 to December 2020 were selected as the objects of this study,and the patients were divided into control group(n=40)and study group(n=40)according to random number method.The control group received radical resection of colon cancer,and the study group received laparoscopic resection of colon cancer+complete mesocolon resection.The treatment effect was compared between the two groups.Results The amount of intraoperative bleeding in the study group was less than that in the control group,the number of lymph node dissections was more than that in the control group,and the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the study group was 7.50%,which was lower than 40.00%in the control group,and the difference was statistically significant(P<0.05).Three days after operation,CD4+and CD4+/CD8+in the study group were higher than those in the control group,CD8+was lower than that in the control group,and the differences were statistically significant(P<0.05).Three days after operation,the counts of Bifidobacterium,Enterococcus faecium and Lactobacillus in the two groups decreased,the counts of Escherichia coli and Yeast increased,but the counts of Bifidobacterium,Enterococcus faecium and Lactobacillus in the study group were more than those in the control group,and the counts of Escherichia coli and Yeast were less than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Laparoscopic resection of colon cancer+complete mesocolon resection can effectively improve the surgical related indexes,postoperative immune function indexes and intestinal flora status of elderly patients with colon cancer,and reduce the incidence of complications.