腹腔镜辅助下结直肠外翻拖出式手术治疗结直肠癌的效果及对患者复发率的影响

Effect of laparoscope-assisted colorectal evaposion and drag operation on colorectal cancer and its influence on the recurrence rate

目的分析腹腔镜辅助下结直肠外翻拖出式手术治疗结直肠癌的效果及对患者复发率的影响。方法选取2017年10月至2022年10月河南科技大学第一附属医院开元院区收治的90例结直肠癌患者为研究对象,按照随机数字表法分为对照组与研究组,每组45例。对照组行腹腔镜直肠前切除术治疗,研究组行腹腔镜辅助下结直肠外翻拖出式手术治疗。比较两组手术指标(术中出血量、手术时间、肠道恢复时间、住院时间、日均排便次数)、免疫功能[分化簇3(CD3^(+))、分化簇4(CD4^(+))、分化簇8(CD8^(+))]水平、血管内皮生长因子(VEGF)-A、VEGF-C水平、疼痛数字评分量表(NRS)评分、并发症发生率及复发率。结果研究组手术时间、肠道恢复时间、住院时间均较对照组短,术中出血量较对照组少,日均排便次数较对照组多(P<0.05)。术后5 d,两组CD3^(+)、CD4^(+)、CD8^(+)水平比较,差异未见统计学意义(P>0.05)。术后5 d,研究组VEGF-A、VEGF-C水平较对照组低(P<0.05)。术后即刻,两组NRS评分比较,差异未见统计学意义(P>0.05)。研究组并发症发生率[4.44%(2/45)]、复发率[2.22%(1/45)]均较对照组[31.11%(14/45)、17.78%(8/45)]低(P<0.05)。结论对结直肠癌患者采用腹腔镜辅助下结直肠外翻拖出式手术治疗,可减轻术后疼痛和免疫功能紊乱,降低并发症发生率、加快术后恢复,并能抑制血管新生,降低复发率。

Objective To analyze the effect of laparoscope-assisted colorectal evaposion and drag operation on colorectal cancer and its influence on the recurrence rate.Methods A total of 90 patients with colorectal cancer in Kaiyuan Hospital of the First Affiliated Hospital of Henan University of Science and Technology from October 2017 to October 2022 were selected and randomly divided into study group and control group,with 45 cases in each group.The control group received laparoscopic anterior rectal resection,and the study group received laparoscopic-assisted colorectal valgus and drag out surgery.The operative indicators(intraoperative blood loss,operative time,intestinal recovery time,hospital stay,average daily defecation times),immune function[differentiation 3(CD3^(+)),differentiation 4(CD4^(+)),differentiation 8(CD8^(+))]levels,vascular endothelial growth factor(VEGF)-A,VEGF-C levels,digital pain scale(NRS)score,complication rates and recurrence rates were compared between the two groups.Results The operation time,intestinal recovery time and hospital stay of the study group were shorter than those of the control group,the amount of intraoperative blood loss was less,and the average daily defecation frequency was more than that of the control group(P<0.05).After 5 days,there were no significant differences in the levels of CD3^(+),CD4^(+)and CD8^(+)between the two groups(P>0.05).After 5 days of operation,the VEGF-A and VEGF-C levels in the study group were lower than those in the control group(P<0.05).Immediately after surgery,there was no significant difference in NRS scores between the two groups(P>0.05).The complication rate of the study group was 4.44%(2/45)and the recurrence rate was 2.22%(1/45),which was lower than those of the control group[31.11%(14/45)and 17.78%(8/45)](P<0.05).Conclusions The use of laparoscope-assisted colorectal evaposion and drag out surgery for colorectal cancer patients can alleviate postoperative pain and immune dysfunction,reduce the incidence of complications,accelerate postoperative recovery,inhibit angiogenesis and reduce the recurrence rate.