侧方入路与中间入路腹腔镜结直肠癌根治术治疗结直肠癌的疗效对比

Comparsion of the clinical efficacy of lateral approach and intermediate approach laparoscopic radical colorectal resection for colorectal cancer

目的比较侧方入路与中间入路腹腔镜结直肠癌根治术在结直肠癌中的治疗效果。方法回顾性分析2019年3月至2020年3月本院收治的62例行腹腔镜结直肠癌根治术的结直肠癌患者的临床资料,将行侧方入路腹腔镜结直肠癌根治术的31例患者纳入对照组,将行中间入路腹腔镜结直肠癌根治术的31例患者纳入观察组。比较两组围术期指标(手术时间、淋巴清除数、术中出血量、排气时间、镇痛时间、住院时间)、癌活性指标[血清Polo样激酶1(PLK1)、X连锁凋亡抑制蛋白(Xiap)、胸苷激酶1(TK1)、凋亡抑制因子Livin]、血管损伤率及并发症(切口感染、口痿、尿路感染)发生率。结果观察组手术时间、镇痛时间、排气时间及住院时间均短于对照组,淋巴清除数多于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。观察组PLK1、Xiap、TK1、Livin水平均低于对照组,差异有统计学意义(P<0.05)。观察组血管损伤率、并发症发生率均低于对照组,差异有统计学意义(P<0.05)。结论中间入路腹腔镜结直肠癌根治术治疗结直肠癌患者可减少术中出血,有效清除淋巴,降低癌活性指标,预防并发症发生,安全性较高,具有较高的临床应用价值。

Objective To compare the clinical efficacy of lateral approach and intermediate approach laparoscopic radical colorectal resection in colorectal cancer.Methods The clinical data of 62 patients with colorectal cancer who underwent laparoscopic radical resection for colorectal cancer treated in our hospital from March 2019 to March 2020 were retrospectively analyzed,31 patients who lateral approach laparoscopic radical colorectal resection were included in the control group,and 31 patients who intermediate approach laparoscopic radical colorectal resection were included in the observation group.The perioperative indexes(operation time,lymph node clearance,intraoperative bleeding,exhaust time,analgesia time,hospitalization time),cancer activity indexes(Polo-like Kinase 1[PLK1],X-linked inhibitor of apoptosis protein[Xiap],thymidine kinase 1[TK1],and inhibitor of apoptosis Livin),vascular injury rate and incidence of complications(incision infection,oral flaccidity,urinary tract infection)were compared between the two groups.Results The operation time,analgesia time,exhaust time and hospitalization time of the observation group were shorter than those of the control group,and the number of lymph node clearance was more than that of the control group,and intraoperative bleeding loss was less than that of the control group,the difference was statistically significant(P<0.05).The levels of PLK1,Xiap,TK1 and Livin of the observation group were lower than those of the control group,the difference was statistically significant(P<0.05).The rate of vascular injury and complications in the observed group was lower than those in the control group,the difference was statistically significant(P<0.05).Conclusion Intermediate approach laparoscopic radical colorectal resection can reduce intraoperative bleeding of colorctal cancer patients,effectively remove lymph nodes,reduce cancer activity indicators and prevent complications,it is safe and has high clinical application value.