保留左结肠动脉联合经自然腔道取标本3D腹腔镜结直肠癌根治术治疗结直肠癌的效果

Effect of 3D Laparoscopic Colorectal Cancer Radical Surgery with Left Colonic Artery Preserved and Specimen Collection through Natural Cavity in the Treatment of Colorectal Cancer

目的:探讨保留左结肠动脉联合经自然腔道取标本3D腹腔镜结直肠癌根治术治疗结直肠癌的效果。方法:选取2019年6月-2020年9月江苏大学附属句容医院拟行保留左结肠动脉3D腹腔镜结直肠癌根治术的60例结直肠癌患者。根据随机数字表法将其分为经自然腔道组和对照组,各30例。两组均给予保留左结肠动脉3D腹腔镜结直肠癌根治术。经自然腔道组经自然腔道取标本,对照组经腹壁切口取标本。比较两组围手术期指标,术后6、12、24、48 h疼痛情况,术前及术后1 d炎症因子,复发及并发症情况。结果:经自然腔道组术中出血量少于对照组,总住院时间短于对照组,术后肛门排气时间早于对照组(P<0.05)。术后6、12、24 h,经自然腔道组数字评分法(NRS)评分低于对照组(P<0.05)。术后1 d,经自然腔道组C反应蛋白(CRP)水平低于对照组(P<0.05),两组降钙素原(PCT)水平比较差异无统计学意义(P>0.05)。经自然腔道组平均随访(8.22±1.94)个月,对照组平均随访(8.37±1.85)个月,两组随访时间比较差异无统计学意义(t=0.307,P>0.05)。随访期间,两组结直肠癌均未见复发。两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论:保留左结肠动脉联合经自然腔道取标本3D腹腔镜结直肠癌根治术效果更好,能够减少术中出血量、减轻术后疼痛、促进胃肠功能恢复。

Objective:To investigate the effect of 3D laparoscopic colorectal cancer radical surgery with left colonic artery preserved and specimen collection through natural cavity in the treatment of colorectal cancer.Method:From June 2019 to September 2020,60 colorectal cancer patients in Jurong Hospital Affiliated to Jiangsu University who planned to undergo 3D laparoscopic colorectal cancer radical surgery with left colonic artery preserved were selected.According to the method of random number table,they were divided into via natural cavity group and control group,30 cases in each group.Both groups were given 3D laparoscopic colorectal cancer radical surgery with left colonic artery preserved.The specimens were taken from the natural cavity in via natural cavity group,in the control group,the specimens were taken through abdominal wall incision.The perioperative indexes,pain condition at 6,12,24,48 h after surgery,inflammatory factors before surgery and 1 d after surgery,recurrence and complications were compared between the two groups.Result:The amount of bleeding during surgery in the via natural cavity group was less than that in the control group,the total hospital stay was shorter than that in the control group,and the time of anal exhaust after surgery was earlier than that in the control group(P<0.05).At 6,12,24 h after surgery,the numerical rating scale(NRS)score in the via natural cavity group were lower than those in the control group(P<0.05).On the 1 d after surgery,the level of C-reactive protein(CRP)in the via natural cavity group was lower than that in the control group(P<0.05),and there was no significant difference in the level of procalcitonin(PCT)between the two groups(P>0.05).The average follow-up time was(8.22±1.94)months in the via natural cavity group and(8.37±1.85)months in the control group,there was no significant difference in follow-up time between the two groups(t=0.307,P>0.05).During follow-up,there was no recurrence of colorectal cancer in both groups.There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:The effect of 3D laparoscopic colorectal cancer radical surgery with left colonic artery preserved and specimen collection through natural cavity is better,which can reduce intraoperative bleeding volume,relieve postoperative pain,and promote the recovery of gastrointestinal function.