无气腹单孔腹腔镜结直肠癌根治术对结直肠癌患者应激反应及并发症的影响

Effect of non-pneumoperitoneum single-port laparoscopic radical resection of colorectal cancer on stress response and complication in patients with colorectal cancer

目的探讨无气腹单孔腹腔镜结直肠癌根治术对结直肠癌患者应激反应及并发症的影响。方法将200例结直肠癌患者按手术方法的不同分为对照组(气腹腹腔镜结直肠癌根治术)和观察组(无气腹单孔腹腔镜结直肠癌根治术),每组100例。比较两组患者手术相关指标、应激反应指标、免疫功能指标、并发症发生情况。结果观察组患者术后肛门排气时间、住院时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。手术开始10 min(T_(1))、术后1 h(T_(2))、术后24 h(T_(3))时,两组患者皮质醇(Cor)、去甲肾上腺素(NE)水平均升高,但观察组患者Cor、NE水平均低于对照组,差异均有统计学意义(P﹤0.05)。手术后,两组患者CD3^(+)、CD4^(+)、CD8^(+)水平及CD4^(+)/CD8^(+)均降低,观察组患者CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于对照组,CD8^(+)水平低于对照组,差异均有统计学意义(P﹤0.05)。两组患者并发症总发生率比较,差异无统计学意义(P﹥0.05)。结论无气腹单孔腹腔镜结直肠癌根治术创伤性较小,可减少手术对患者的刺激,避免患者手术过程中引发应激反应,有助于增强患者的免疫力,且该手术无需建立气腹,可有效加快患者术后肛门排气速度,促使患者恢复,可在一定程度上缩短患者的住院时间。

Objective To investigate the effect of non-pneumoperitoneum single-port laparoscopic radical resection of colorectal cancer on stress response and complication in patients with colorectal cancer.Method A total of 200 patients with colorectal cancer were divided into control group(pneumoperitoneum laparoscopic radical resection of colorectal cancer)and observation group(non-pneumoperitoneum single-port laparoscopic radical resection of colorectal cancer)according to different surgical methods,with 100 cases in each group.The operation-related indicators,stress response indicators,immune function indicators,and complications were compared between the two groups.Result The postoperative anal exhaust time and hospital stay in the observation group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.01).At 10 minutes after the operation(T_(1)),1 hour after the operation(T_(2)),and 24 hours after the operation(T_(3)),the levels of cortisol(Cor)and norepinephrine(NE)in the two groups increased,the levels of Cor and NE in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the operation,the levels of CD3^(+),CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)in both groups decreased,the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,and the level of CD8^(+)was lower than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Non-pneumoperitoneum single-port laparoscopic radical resection of colorectal cancer causes less trauma in the treatment of colorectal cancer,which could reduce the stimulation of the operation to the patient,avoid the stress response during the operation,and help to enhance immunity.Moreover,the operation does not require the establishment of pneumoperitoneum,which would effectively accelerate the postoperative anal exhaust speed of the patient,promote the recovery of the patient,and shorten the hospital stay to a certain extent.