腹腔镜直肠癌根治术对早期直肠癌患者肠道屏障功能的影响

Effect of Laparoscopic Radical Resection of Rectal Cancer on Intestinal Barrier Function in Patients with Early Stage Rectal Cancer

目的:探讨腹腔镜直肠癌根治术对早期直肠癌患者术后肠道屏障功能的影响。方法:选取2018年1月—2022年1月沭阳中兴医院收治的82例拟行手术治疗的早期直肠癌患者为研究对象,依照随机数表法分为试验组和对照组,各41例。其中,试验组采用腹腔镜直肠癌根治术,对照组采用开腹直肠癌根治术。比较两组术中出血量、手术时间,肠道屏障功能指标[血浆D-乳酸、血浆二胺氧化酶(DAO)]、术后排气时间、肠鸣音恢复时间及吻合口瘘发生率。结果:试验组术中出血量少于对照组,手术时间短于对照组,差异有统计学意义(P<0.05)。术前,两组血浆D-乳酸、DAO水平比较,差异无统计学意义(P>0.05);术后12 h,两组血浆D-乳酸、血浆DAO水平均高于术前,但试验组血浆D-乳酸、DAO水平均低于对照组,差异有统计学意义(P<0.05)。试验组术后排气时间、肠鸣音恢复时间均早于对照组,差异有统计学意义(P<0.05)。试验组吻合口瘘发生率低于对照组,差异有统计学意义(P<0.05)。结论:与常规开腹手术相比,腹腔镜直肠癌根治术治疗早期直肠癌患者,有利于改善肠道屏障功能,术中出血量更少、手术时间更短,术后排气时间、肠鸣音恢复时间明显提前,吻合口瘘发生率更低。

Objective:To explore the effect of laparoscopic radical resection of rectal cancer on intestinal barrier function in early stage rectal cancer patients.Method:A total of 82 patients with early stage rectal cancer who were scheduled for surgical treatment at Shuyang Zhongxing Hospital from January 2018 to January 2022 were selected as the study objects,and they were divided into experimental group and control group using a random number table method,with 41 patients in each group.Among them,the experimental group underwent laparoscopic radical resection of rectal cancer,while the control group underwent open radical resection of rectal cancer.The bleeding volume,operation time,intestinal barrier function index[plasma D-lactic acid,plasma Diamine oxidase(DAO)],postoperative exhaust time,recovery time of bowel sounds and incidence of anastomotic fistula between the two groups were compared.Result:The intraoperative bleeding volume in the experimental group was less than that in the control group,and the operation time was shorter than that in the control group,the differences were statistically significant(P<0.05).Before surgery,there were no statistically significant differences in plasma D-lactate and DAO levels between the two groups(P>0.05).At 12 h after surgery,the levels of plasma D-lactate and DAO in both groups were higher than those before surgery,but the plasma D-lactate and DAO in the experimental group were lower than those in the control group,the differences were statistically significant(P<0.05).The postoperative exhaust time and recovery time of bowel sounds in the experimental group were earlier than those in the control group,the differences were statistically significant(P<0.05).The incidence of anastomotic fistula in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Compared with conventional open surgery,laparoscopic radical resection of rectal cancer is beneficial to improve intestinal barrier function in patients with early stage rectal cancer,with fewer intraoperative bleeding,shorter operation time,significantly earlier postoperative exhaust time,significantly earlier recovery time of bowel sounds,and lower incidence of anastomotic leakage.