TEM治疗直肠神经内分泌肿瘤的疗效及其对机体炎症反应的影响  

Effect of TEM in treating rectal neuroendocrine tumor and its influence on inflammatory response

作　　者：刘琳[1] 郑奇 向省平 潘柏莉 陈艳[1] Liu Li;Zheng Qi;Xiang Shengping;Pan Boli;Chen Yan(Clinical Laboratory,Tibet Branch of West China Hospital of Sichuan University,Chengdu 610041,Sichuan,China;Clinical Laboratory,Chengfei Hospital,Chengdu 610091,Sichuan,China)

机构地区：[1]四川大学华西医院西藏成办分院检验科,四川成都610041 [2]成飞医院检验科,四川成都610091

出　　处：《结直肠肛门外科》2019年第2期226-229,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨经肛门内镜微创手术(TEM)治疗直肠神经内分泌肿瘤的临床效果及其对机体炎症反应的影响。方法回顾性分析2016年1月至2018年1月四川大学华西医院西藏成办分院与成飞医院108例直肠神经内分泌肿瘤患者的临床资料,根据手术方式分为两组,其中48例采用TEM手术治疗(TEM组),另外60例采用传统经肛门局部切除术(传统组)。对比两组患者的手术时间、术后首次肛门排气时间、平均住院时间及标本切缘阴性率;分别在术前、术后3 d测定患者血清C反应蛋白(CRP)、白介素-6 (IL-6)、白介素-8 (IL-8)水平,评估机体炎症反应情况;比较两组并发症发生率。结果 TEM组手术时间、术中出血量、术后首次肛门排气时间、平均住院时间均短于传统组,术中出血量少于对照组,差异均有统计学意义(均P <0.05),两组标本切缘阴性率均为100.00%;术前,两组血清CRP、IL-6、IL-8水平比较差异均无统计学意义(均P> 0.05);术后3 d,TEM组血清CRP、IL-6、IL-8水平均低于传统组(均P <0.05);TEM组术后并发症发生率为4.17%,传统组术后并发症发生率为8.33%,两组比较差异无统计学意义(P> 0.05)。结论与传统经肛门局部切除术相比,TEM治疗直肠神经内分泌肿瘤的创伤更小,术后炎症反应程度低。Objectives To investigate effect of transanal endoscopic microsurgery(TEM)in treating rectal neuroendocrine tumor and its influence on inflammatory response.Methods This was a retrospective analysis of clinical data of 108 patients with rectal neuroendocrine tumor treated between January 2016 and Jaunary 2018 in Tibet Branch of West China Hospital of Sichuan University and Chengfei Hospital.Patients were divided into two groups based on the surgical approach.Patients in the TEM group received TEM(n=48)and those in the traditional group received transanal local resection(n=60).Duration of surgery,intraoperative blood loss,first anal exhaust time after surgery,average duration of hospitalization,percentage of negative resection margin and the incidence of complications were compared between the two groups.Serum levels of C-reactive protein(CRP),interleukin 6(IL-6)and interleukin 8 IL-8 were evaluated before and 3 days after surgery to evaluate the inflammatory response of patients.Results Duration of surgery,intraoperative blood loss,first anal exhaust time after surgery,and average duration of hospitalization were significantly shorter or less in the TEM group than in the traditional group(P<0.05).Percentage of negative resection margin was 100.00%in both groups.There was no significant difference between the two groups in serum levels of CRP,IL-6 and IL-8 before surgery(P>0.05),but 3 days after surgery,these levels were significantly lower in the TEM group than in the traditional group(P<0.05).Incidence of postoperative complications was 4.17%in the TEM group and 8.33%in the traditional group,with no significant between-group difference(P>0.05).Conclusion Compared with traditional transanal local resection,TEM is associated with smaller injury and fewer postoperative inflammatory response in treating rectal neuroendocrine tumor.

关 键 词：直肠神经内分泌肿瘤 经肛门内镜微创手术 炎症反应 

分 类 号：R735.3[医药卫生—肿瘤]