保留植物神经右半结肠癌根治术安全性和有效性研究  

Safety and efficacy of radical surgery for right colon cancer with autonomic nerve preservation

作　　者：王铎[1] WANG Duo(Department of General Surgery, Second Affliated Hospital of Xi’an Medical College,Xi’an 710038)

机构地区：[1]西安医学院第二附属医院普外科

出　　处：《陕西医学杂志》2019年第8期1059-1062,共4页Shaanxi Medical Journal

摘　　要：目的:探究保留植物神经的腹腔镜右半结肠癌根治术的安全性及临床疗效。方法:选取右半结肠癌患者86例,根据随机数表法分为研究组(n=43)和对照组(n=43)。其中对照组患者行未保留植物神经的右半结肠癌根治术,研究组患者行保留植物神经的右半结肠癌根治术。比较两组患者手术前后血清血管内皮生长因子(VEGF)、结肠癌特异性抗原-2(CCSA-2)、中期因子(MK)等肿瘤标志物水平。比较两组患者手术时间、术中出血量、淋巴结清扫数目、住院时间等围术期相关指标和首次排气时间、肠鸣音恢复时间、术后进食时间、留置导管时间等胃肠功能指标。观察并记录两组患者术后并发症发生情况。结果:两组患者治疗前后血清VEGF、CCSA-2、MK水平的比较无统计学差异(P>0.05);两组患者首次排气时间、肠鸣音恢复时间、术后进食时间、留置导管时间、术中出血量、淋巴结清扫数目、住院时间的比较无统计学差异(P>0.05),但研究组患者手术时间显著短于对照组(P<0.05);研究组患者术后肠梗阻、腹泻、腹痛、吻合口瘘的发生率分别为2.33%(1/43)、4.65%(2/43)、2.33%(1/43)、2.33%(1/43)均显著低于对照组的[13.95%(6/43)、16.28%(7/43)、13.95%(6/43)、16.28%(7/43),P<0.05],两组患者切口感染发生率的比较无统计学差异(P>0.05)。结论:保留植物神经的右半结肠癌根治术对肠系膜上动脉血管鞘进行保留,对近期胃肠功能无明显影响,但可明显降低术后胃肠功能紊乱等并发症。Objective: To investigate the safety and clinical efficacy of laparoscopic right colon cancer with autonomic nerve preservation. Methods: Eighty-six patients with right colon cancer were enrolled. The patients were divided into study group(n=43) and control group(n=43) according to the random number table method. The patients in the control group underwent radical surgery for right colon cancer without preservation of autonomic nerves, and the patients in the study group underwent radical resection of the right colon of the colon. The levels of serum vascular endothelial growth factor(VEGF), colon cancer specific antigen-2(CCSA-2), and midkine(MK) were compared before and after surgery. Perioperative related indicators such as operation time, intraoperative blood loss, lymph node dissection, hospitalization time, and gastrointestinal function indicators such as first exhaust time, recovery time of bowel sounds, postoperative feeding time, and indwelling catheter timewere compared between the two groups. The postoperative complications of the two groups were observed and recorded. Results: There were no significant differences in serum VEGF, CCSA-2 and MK levels between the two groups before and after treatment(P>0.05);there was no significant difference in the first exhaust time, recovery time of bowel sounds, postoperative feeding time, indwelling catheter time, intraoperative blood loss, lymph node dissection, and hospitalization time between the two groups(P>0.05), however, the operation time of the study group was significantly shorter than that of the control group(P<0.05);the incidence of postoperative intestinal obstruction, diarrhea, abdominal pain, and anastomotic leakage were 2.33%(1/43), 4.65%(2/43), 2.33%(1/43), 2.33%(1/43) were significantly lower than the control group [13.95%(6/43), 16.28%(7/43), 13.95%(6/43), 16.28%(7/43), P<0.05], there was no significant difference in the incidence of incision infection between the two groups(P>0.05). Conclusion: The preservation of the superior mesenteric vascu

关 键 词：腹腔镜 右半结肠癌根治术 植物神经 疗效 安全性 对比研究 

分 类 号：R735.3[医药卫生—肿瘤]