摘要
目的:比较腹腔镜与传统开腹手术治疗结直肠癌对患者短期康复和远期预后的差异。方法:回顾性分析江苏省常熟市第一人民医院2017年4月至2019年4月手术治疗的86例结肠癌患者的临床资料,根据手术方法不同分为观察组(腹腔镜下行结肠癌根治术,41例)和对照组(传统开腹术行结肠癌根治术,45例),比较两组手术指标、短期恢复情况、并发症发生情况、血清抗炎与促炎因子水平以及3年无瘤生存率。结果:与对照组比较,观察组术中出血量少[(120.32±32.43)ml比(178.43±39.98)ml],首次下床时间、肛门排气时间、进食半流质时间更早[(2.10±0.23)d比(3.03±0.54)d、(3.45±1.02)d比(4.29±1.03)d、(4.54±1.09)d比(5.30±1.05)d],住院时间短[(9.65±2.17)d比(12.35±2.68)d],差异均有统计学意义(P<0.05)。观察组并发症发生率低于对照组[12.20%(5/41)比31.11%(14/45)],差异有统计学意义(χ2=4.695,P<0.05)。观察组术后3 d血清白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α水平低于对照组[(23.12±6.09)μg/L比(31.05±5.3)μg/L、(57.87±10.6)μg/L比(62.43±6.8)μg/L],IL-4、转化生长因子(TGF)-β水平高于对照组[(155.03±14.53)ng/L比(127.87±12.09)ng/L、(26.32±3.09)ng/L比(20.87±3.87)ng/L],差异均有统计学意义(P<0.05)。两组术后3年无瘤生存率比较差异无统计学意义(P>0.05)。结论:腹腔镜治疗结肠癌具有创伤小,并发症少,术后炎性反应轻的优势,并且具有与传统开腹术相当的远期预后。
Objective To compare the short-term recovery and long-term prognosis of patients with colorectal cancer by laparoscopy and traditional open surgery.Methods The clinical data of 86 patients with colon cancer treated by the Changshu NO.1 People′s Hospital from April 2017 to April 2019 were retrospectively analyzed.According to different surgical methods,they were divided into observation group(laparoscopic radical resection of colon cancer,41 cases)and the control group(traditional laparotomy underwent radical resection of colon cancer,45 cases).The surgical indicators,short-term recovery,complications,serum anti-inflammatory and pro-inflammatory factor levels,and 3-year tumor-free survival rate between two groups were compared.Results Compared with the control group,the observation group had less intraoperative blood loss and shorter hospital stay:(120.32±32.43)ml vs.(178.43±39.98)ml,(9.65±2.17)d vs.(12.35)±2.68)d;the time to get out of bed for the first time,the time of anal exhaust and the time of eating semiliquid in the observation group were earlier:(2.10±0.23)d vs.(3.03±0.54)d,(3.45±1.02)d vs.(4.29±1.03)d,(4.54±1.09)d vs.(5.30±1.05)d,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group:12.20%(5/41)vs.31.11%(14/45),the difference was statistically significant(χ2=4.695,P<0.05).Serum interleukin(IL)-6 and tumor necrosis factor(TNF)-αlevels in the observation group were lower than those in the control group:(23.12±6.09)μg/L vs.(31.05±5.3)μg/L,(57.87±10.6)μg/L vs.(62.43±6.8)μg/L;serum IL-4 and transforming growth factor(TGF)-βlevels were higher than those in the control group:(155.03±14.53)ng/L vs.(127.87±12.09)ng/L,(26.32±3.09)ng/L vs.(20.87±3.87)ng/L,the differences were statistically significant(P<0.05).There was no significant difference in the tumor-free survival rate between the two groups at 3-year after operation(P>0.05).Conclusions Laparoscopic treatment of colon cancer has the advantages of less trauma,fewer complications,and mild postoperative inflammatory reaction,and has a long-term prognosis comparable to traditional laparotomy.
作者
陆欢
缪文忠
朱鹏程
Lu Huan;Miao Wenzhong;Zhu Pengcheng(Department of General Surgery,Changshu Hospital Affiliated of Soochow University,Changshu No.1 People′s Hospital,Jiangsu Changshu 215500,China)
出处
《中国医师进修杂志》
2021年第8期701-705,共5页
Chinese Journal of Postgraduates of Medicine
关键词
腹腔镜
结肠肿瘤
传统开腹术
短期康复
远期预后
Laparoscopy
Colon neoplasms
Traditional laparotomy
Short-term rehabilitation
Long-term prognosis
