腹腔镜与开腹直肠癌全系膜切除术有效性及并发症研究  

The efficacy and complications of total membranous resection of laparoscopic and open rectal cancer

作　　者：汪黎明 蒋文俊 陈亚川 张燕 WANG Liming;JIANG Wenjun;CHEN Yachuan;ZHANG Yan(Department of General Surgery,the Second Hospital of Sichuan Traditional Chinese Medicine,Chengdu,Sichuan 610031,China)

机构地区：[1]四川省第二中医医院普外科,成都610031

出　　处：《重庆医学》2019年第S02期113-116,共4页Chongqing medicine

摘　　要：目的探讨腹腔镜与开腹直肠癌全系膜切除术治疗直肠癌患者的临床疗效及并发症发生情况。方法选取2016年8月至2018年4月该院收治的直肠癌患者40例,采用随机数字法分为研究组和对照组,每组20例。对照组予以开腹直肠癌全系膜切除术治疗,研究组予以腹腔镜直肠癌全系膜切除术治疗。比较两组患者切口长度、术中出血量、手术时间、下床活动时间、拔管时间、排气时间、进食时间、住院时间、并发症发生情况及手术前后免疫功能指标变化情况。结果研究组患者切口长度、术中出血量均明显小于对照组,手术时间明显长于对照组,下床活动时间、拔管时间、排气时间、进食时间、住院时间均明显短于对照组,并发症发生率明显低于对照组,差异均有统计学意义(P<0.05)。两组患者干预前免疫功能指标比较,差异无统计学意义(P>0.05),两组患者干预后CD3+、CD4+、CD8+均明显降低,白细胞介素-6、C反应蛋白均明显升高,且对照组较研究组改变明显,差异均有统计学意义(P<0.05)。结论腹腔镜全系膜切除术治疗直肠癌对患者损伤小,对患者免疫功能的影响小,术后并发症少,术后恢复快。值得在临床上推广使用。Objective To investigate the clinical efficacy and complications of laparoscopic and open-thoracic carcinoma with total mesenteric resection for rectal cancer.Methods Forty patients with rectal cancer admitted to our hospital from August 2016 to April 2018 were enrolled according to the random number method.The control group was treated with total mesorectal excision for rectal cancer.Twenty patients underwent laparoscopic rectal cancer with total mesenteric resection.Incision length,intraoperative blood loss,operation time,time to get out of bed,extubation time,exhaust time,eating time,hospitalization time,complications,and changes in immune function indexes before and after surgery were compared between the two groups.Results The length of incision and intraoperative blood loss in the study group was significantly lower than that in the control group.The operation time was significantly longer than that in the control group.The time of getting out of bed,extubation time,exhaust time,eating time and hospitalization time were significantly shorter than the control group(P<0.05).The complication rate of the study group(10.00%)was significantly lower than that of the control group(50.00%)(P<0.05).There was no significant difference in the immune function indexes between the two groups(P>0.05).After intervention,the CD3+,CD4+,and CD8+levels were significantly decreased,IL-6 and CRP were significantly increased,and the control group changed significantly compared with the study group(P<0.05).Conclusion Laparoscopic total mesenteric resection for rectal cancer has less damage to patients,has less impact on immune function,less postoperative complications,and quick recovery after surgery.It is worth promoting in clinical use.

关 键 词：腹腔镜全系膜切除术 直肠癌 开腹手术 免疫功能 

分 类 号：R73[医药卫生—肿瘤]