腹腔镜辅助与传统开腹结肠癌根治术对Ⅱ/Ⅲ期结肠癌患者术后肠道功能及远期预后的影响

Effects of Laparoscopic Assisted and Traditional Laparotomy Radical Surgery for Colon Cancer on Postoperative Intestinal Function and Long-term Prognosis in Patients with StageⅡ/ⅢColon Cancer

目的:探讨腹腔镜辅助与传统开腹结肠癌根治术治疗Ⅱ/Ⅲ期结肠癌患者的手术情况及对术后肠道功能、远期预后的影响。方法:纳入2020年5月—2021年11月萍乡矿业集团有限责任公司总医院收治的78例Ⅱ/Ⅲ期结肠癌患者,将患者随机分成对照组(n=39)与观察组(n=39),其中对照组应用传统开腹结肠癌根治术,而观察组则进行腹腔镜辅助结肠癌根治术。统计两组患者手术情况,记录术后肠道功能,并随访2年调查其远期预后情况。结果:观察组手术时间短于对照组,术中出血量少于对照组,手术切口长度、住院时长均短于对照组,差异均有统计学意义(P<0.05)。观察组术后肠鸣音恢复正常时间、术后肛门排气时间、术后进流食时间及术后肛门排便时间均早于对照组,差异均有统计学意义(P<0.05)。术前,两组胃泌素、胃动素水平比较,差异均无统计学意义(P>0.05);术后1周,观察组胃泌素与胃动素水平均低于对照组,差异均有统计学意义(P<0.05)。随访调查发现观察组患者并发症发生率、局部复发率及远处转移率与对照组比较,差异均无统计学意义(P>0.05)。结论:腹腔镜辅助与传统开腹结肠癌根治术在治疗Ⅱ/Ⅲ期结肠癌患者均有良好的效果,但前者手术治疗效果显著更优,能减小手术风险,促进术后恢复,在改善胃肠激素的同时还能提高患者肠胃功能,有较好的安全性及远期疗效。

Objective:To investigate the surgical outcomes of laparoscopic assisted versus traditional open radical surgery for colon cancer in patients with stageⅡ/Ⅲcolon cancer,and their effects on postoperative intestinal function and long-term prognosis.Method:A total of 78 patients with stageⅡ/Ⅲcolon cancer who were admitted to General Hospital of Pingxiang Mining Group Co.from May 2020 to November 2021 were selected,they were randomly divided into the control group(39 cases)and the observation group(39 cases).The control group received traditional laparotomy radical surgery for colon cancer,the observation group received laparoscopic assisted radical surgery for colon cancer.Surgical conditions of the two groups were analyzed,and postoperative intestinal function was recorded,all patients were followed up for 2 years to investigate their long-term prognosis.Result:Surgical time of the observation group was shorter than that of the control group,the intraoperative blood loss was less than that of the control group,surgical incision and hospital stay were significantly shorter than those of the control group,the differences were statistically significant(P<0.05).The postoperative recovery time for bowel sounds,postoperative anal exhaust time,postoperative time for eating liquid food and postoperative anal defecation time in the observation group were significantly earlier than those in the control group,the differences were statistically significant(P<0.05).Before surgery,there were no statistically significant differences in the levels of gastrin or motilin between the two groups(P>0.05);1 week after surgery,the levels of gastrin and motilin in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Follow-up survey found that the incidence of complications,local recurrence rate and distant metastasis rate in the observation group compared to the control group,the differences were not statistically significant(P>0.05).Conclusion:Both laparoscopic assisted and traditional laparotomy radical surgery for colon cancer can achieve good results in the treatment of stageⅡ/Ⅲcolon cancer.However,therapeutic effect of the former is significantly better as it can not only reduce surgical risk and promote postoperative recovery,but also improve gastrointestinal hormones and gastrointestinal function.Its safety and long-term efficacy are better.