摘要
目的研究腹腔镜下全结肠系膜切除术(CEM)对右半结肠癌患者营养状况及安全性的影响。方法将100例右半结肠癌患者按照随机数字法分为腹腔镜组和开腹组,每组50例。腹腔镜组行腹腔镜下CEM,开腹组行开腹CEM。观察2组手术时间、术中出血量、肛门排气时间、肛门排便时间、淋巴结清扫个数、术后进食时间、住院时间、术后并发症发生率,比较2组治疗前后前白蛋白(PA)、白蛋白(Alb)、血红蛋白(Hb)、淋巴细胞(LC)、预后营养指数(PNI)变化情况,随访1年比较2组复发转移情况及生存率。结果腹腔镜组手术时间、术中出血量均少于开腹组(P<0.05),肛门排气、排便时间及术后进食时间早于开腹组(P<0.05),淋巴结清扫个数多于开腹组(P<0.05),住院时间少于开腹组(P<0.05)。2组术后并发症发生率差异有统计学意义(P<0.05)。术后,2组Alb、PA、Hb、LC及PNI水平均较术前有所下降,但腹腔镜组下降较治疗前比较差异无统计学意义(P>0.05),开腹组Alb、PA及Hb、LC、PNI较术前明显下降,且低于腹腔镜组,差异均有统计学意义(P<0.05)。2组1年复发转移率及生存率比较差异无统计学意义(P>0.05)。结论腹腔镜下CME治疗右半结肠癌能有效改善患者营养状况,安全有效。
Objective To investigate the effects of laparoscopic total mesentery excision(CEM)on the nutritional status and safety of patients with right colon cancer.Methods A total of 100 patients with right colon cancer were randomly divided into two groups according to random number method,with 50 patients in each group.CEM was performed under laparoscope in laparoscopic operation group,and CEM was performed in the open abdomen operation group.The operation time,intraoperative blood loss,anal exhaust time,anal defecation time,lymph node dissection,postoperative feeding time,hospital stay,postoperative complication rate,blood albumin before the test,PNI,recurrence and metastasis as well as survival rate after 1-year follow-up were observed and compared between the two groups.Results The operation time and intraoperative blood loss and hospital stay in laparoscopic operation group were significantly less than those in open abdomen operation group(P<0.05),and the anal exhaust time,defecation time,and postoperative feeding time in laparoscopic operation group were significantly earlier than those in open abdomen operation group(P<0.05).And the numbers of lymph node dissections in laparoscopic operation group were significantly more than those in open abdomen operation group(P<0.05).There was a significant differnce in the incidence rate of postoperative complications between the two groups(P<0.05).After operation,the levels of Alb,PA and Hb,LC,and PNI in both groups were decreased,but the differences were not significant in laparoscopic operation group(P<0.05).The levels of Alb,PA,Hb,LC,and PNI in open abdomen operation group were significantly decreased after operation,moreover,which were significantly lower than those in laparoscopic operation group(P<0.05).In addition there were no significant differences in 1-year recurrence and metastasis rate and survival rate between the two groups(P>0.05).Conclusion Laparoscopic CME is a safe and effective treatment way for right colon cancer,which can effectively improve the nutritional status of patients.
作者
杨永强
陈稳
张国栓
杨月婷
智英辉
陈良
YANG Yongqiang;CHEN Wen;ZHANG Guoshuan(Department of General Surgery,People’s Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050031,China;不详)
出处
《河北医药》
CAS
2020年第22期3379-3382,3387,共5页
Hebei Medical Journal
基金
石家庄市科学技术研究与发展自筹计划项目(编号:191460883)。
关键词
右半结肠癌
腹腔镜
营养状况
right colon cancer
laparoscopy
nutritional status
