手术隔离技术在结直肠癌根治术中的应用效果

Efficacy of surgical isolation techniques in patients undergoing radical resection for colorectal cancer

目的 探讨手术隔离技术在结直肠癌根治术患者中的应用效果。方法 选取2017年6月至2020年6月间宝鸡市中医医院收治的行结直肠癌根治术治疗的90例结直肠癌患者进行研究,将2017年6月至2018年6月间收治的45例未采用手术隔离技术的根治术患者分为对照组,将2018年7月至2020年6月间收治的45例采用手术隔离技术的根治术患者分为观察组。比较两组患者的治疗效果,术后2年局部复发率、远处转移率、无进展生存时间和总生存时间,手术前后肿瘤标志物水平及术后并发症发生率。结果 观察组患者客观缓解率和疾病控制率均高于对照组,差异均有统计学意义(均P<0.05)。术后2年,观察组患者局部复发率、远处转移率均低于对照组,无进展生存时间和总生存时间均高于对照组,差异均有统计学意义(均P<0.05)。术后3周,两组患者血清甲胎蛋白、胰岛素样生长因子结合蛋白-2和胰岛素样生长因子-Ⅱ水平均降低,但两组比较,差异无统计学意义(P>0.05)。观察组患者并发症总发生率为11.1%,低于对照组的28.9%,差异有统计学意义(P<0.05)。结论 在结直肠癌根治术中采用手术隔离技术,能提高患者的手术治疗效果,降低局部复发率和远处转移率,进一步提升生存时间,降低肿瘤标志物水平,减少并发症发生率,值得临床应用推广。

Objective To investigate the efficacy of surgical isolation techniques in patients undergoing radical resection for colorectal cancer. Methods A total of 90 colon cancer patients who underwent radical resection for colorectal cancer at Baoji Hospital of Traditional Chinese Medicine were selected from June 2017 to June 2020. Forty-five patients undergoing radical surgery for colorectal cancer with surgical isolation technology were enrolled in an observation group from July 2018 to June 2020 and 45 patients undergoing radical surgery for colon cancer without surgical isolation technology were enrolled in a control group June 2017 to June 2018. The local recurrence rate, distant metastasis rate, progression-free survival and overall survival at 2 years after the surgery, tumor marker levels before surgery and 3 weeks after surgery, and incidence of postoperative complications were compared between the two groups. Results The objective remission rate and disease control rate were higher in the observation group than in the control group(all P<0.05). At 2 years after the surgery, the local recurrence rate and distant metastasis rate were significantly lower in the observation group than in the control group, and the progression free survival and overall survival were significantly higher in the observation group than in the control group(all P<0.05). At 3 weeks after the operation, the levels of insulin-like growth factor binding protein-2(IGFBP-2), insulin-like growth factor-Ⅱ(IGF-Ⅱ) and alpha fetoprotein(AFP) decreased in both groups but there was no significant difference between the two groups(P>0.05). The incidence of complications was 11.1% in the observation group which was significantly lower than 28.9% of the control group(P<0.05). Conclusion Surgical isolation technology applied to radical resection for colorectal cancer can improve the therapeutic efficacy of radical resection for colorectal cancer, reduce the local recurrence rate and distant metastasis rate, further improve the survival, reduce the level of tumor markers and the incidence of complications. It is worthy of clinical application and promotion.