腹腔镜下直肠癌前切除术治疗低位直肠癌的效果及对复发情况的影响

Effect of laparoscopic anterior resection of rectal cancer in the treatment of low rectal cancer and its influence on recurrence

目的探讨腹腔镜下直肠癌前切除术治疗低位直肠癌的效果及对复发情况的影响。方法选取2019年4月至2022年4月收治的80例低位直肠癌患者为研究对象,按照随机数字表法将其分为对照组和观察组,每组40例。对照组采取常规开腹手术治疗,观察组采取腹腔镜下直肠癌前切除术。比较两组的治疗效果。结果观察组的手术时间、住院时间短于对照组,术中出血量少于对照组,数字评定量表(NRS)评分低于对照组,差异具有统计学意义(P<0.05)。两组的淋巴结清扫数目、切除标本长度及复发率比较,差异无统计学意义(P>0.05)。术前,两组的免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、癌胚抗原(CEA)水平比较,差异无统计学意义(P>0.05);术后1、7 d,两组的IgA、IgM、IgG、CEA水平比较,差异无统计学意义(P>0.05);术后1、7 d,观察组的IL-6、CRP水平均低于对照组,差异具有统计学意义(P<0.05);术后1、7 d,两组的CEA水平低于术前,差异具有统计学意义(P<0.05)。结论腹腔镜下直肠癌前切除术治疗低位直肠癌效果显著,可缩短手术时间,减少术中出血量,减轻疼痛及应激反应,值得应用。

Objective To explore the effect of laparoscopic anterior resection of rectal cancer in the treatment of low rectal cancer and its influence on recurrence.Methods A total of 80 patients with low rectal cancer admitted from April 2019 to April 2022 were selected as the research objects and divided into control group and observation group according to the random number table method,with 40 cases in each group.The control group was treated with conventional open surgery,and the observation group was treated with laparoscopic anterior resection of rectal cancer.The therapeutic effects of the two groups were compared.Results The operation time and hospitalization time of the observation group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,the Numerical Rating Scale(NRS)score was lower than that of the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the number of lymph node dissection,length of resected specimen and recurrence rate between the two groups(P>0.05).Before operation,there were no significant differences in the levels of immunoglobulin A(IgA),immunoglobulin M(IgM),immunoglobulin G(IgG),interleukin-6(IL-6),C-reactive protein(CRP)and carcinoembryonic antigen(CEA)between the two groups(P>0.05);at 1 and 7 d after operation,there were no significant differences in the levels of IgA,IgM,IgG and CEA between the two groups(P>0.05);at 1 and 7 d after operation,the levels of IL-6 and CRP in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05);at 1 and 7 d after operation,the level of CEA in the two groups was lower than that before operation,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic anterior resection of rectal cancer is effective in the treatment of low rectal cancer.It can shorten the operation time,reduce the intraoperative blood loss,relieve pain and stress response,which is worthy of application.