腹腔镜与开腹老年结直肠癌根治术的疗效及术后炎性反应的影响比较  

Comparison of the therapeutic effects and inflammatory response after radical resection of rectal carcinoma between laparoscopy and laparotomy in elderly patients with colorectal cancer

作　　者：陈建伯[1] 王云玲[2] 

机构地区：[1]河南省郑州市第一人民医院普外科,454000 [2]河南省郑州市第一人民医院超声科,454000

出　　处：《河北医药》2015年第21期3212-3215,共4页Hebei Medical Journal

摘　　要：目的比较腹腔镜与开腹对老年结直肠癌根治术的疗效和术后炎性反应的影响。方法选取收治的行结直肠癌手术的老年患者76例。依据手术方法不同,分为腹腔镜组(A组,n=34)和开腹组(B组,n=42)。比较2组治疗效果及血液和腹腔引流液中白细胞(WBC)、白介素-6(IL-6)、白介素-10(IL-10)以及肿瘤坏死因子-α(TNF-α)各炎性反应指标水平。结果 A组手术时间、术后第1天引流量、淋巴结清扫数目、术后局部复发率和转移率比较,差异无统计学意义(P>0.05)。A组术中出血量、术后第4天腹腔引流量、排气时间、住院时间、手术切口长度以及并发症发生均较B组降低或缩短,差异有统计学意义(P<0.05)。2组患者术前血清各炎性因子比较,差异无明显统计学意义(P>0.05);2组患者术后第1天和第4天时血清各炎性反应指标均较术前明显升高(P<0.05)。A组患者术后第1天血清和腹腔引流液中各炎性反应指标明显低于B组(P<0.05),术后第4天时A组血清和腹腔引流液中各炎性反应指标虽低于B组,但2组差异无统计学意义(P>0.05)。结论腹腔镜下进行老年结直肠癌的根治手术可达到与传统开腹手术的类似根治效果,且腹腔镜根治术还具有创伤小、恢复快以及对炎性反应影响小等优势,值得临床推广。Objective To compare the differences of therapeutic effects and inflammatory response after radical resection of rectal carcinoma between laparoscopy and laparotomy in elderly patients with colorectal cancer. Methods Seventy- six patients with colorectal cancer who received radical resection of rectal carcinoma in our hospital from March 2012 to May2014 were enrolled in the study. These patients were divided into laparoscopy group（ n = 34） and laparotomy group（ n =42） according to different operation methods. The therapeutic effects,the levels of white blood cells（ WBC）,interleukin 6（ IL-6）,interleukin 10（ IL-10） and tumor necrosis factor-α（ TNF-α） in serum and abdominal cavity draining liquid were detected and compared between two groups. Results There were no significant differences in general data between two groups（ P〈0. 05）. There were no significant differences in operative time,draining volume on 1d after operation,resected lymph node number,local recurrence rate and metastasis rate after operation between two groups（ P〈0. 05）. However the intraoperative hemorrhage volume,abdominal cavity draining volume on 4d after operation,venting time,the length of operative incision in laparoscopy group were significantly decreased,as compared with those in laparotomy group（ P〈0. 05）. There were no significant differences in serum inflammatory factors before operation between two groups（ P〈0. 05）. However the inflammatory factors on 1d,4d after operation in both groups were obviously increased（ P〈0. 05）. Moreover the inflammatory factors in serum and abdominal cavity draining liquid on 1d after operation in laparoscopy group were significantly lower than those in laparotomy groups（ P〈0. 05）,besides,the inflammatory factors on 4d after operation in laparoscopy group were lower than those in laparotomy group,but there were no significant differences between two groups（ P〈0. 05）.Conclusion Both laparoscopy and laparotomy can obtain similar radical effect

关 键 词：腹腔镜 开腹 结直肠肿瘤 老年人 根治性治疗 炎性反应 

分 类 号：R735.37[医药卫生—肿瘤]