腹腔镜下全结肠系膜切除对右半结肠癌根治术患者手术效果及恢复情况的影响  

Impact of laparoscopic CME on the operation effect and recovery of patients underwent radical resection of right colon cancer

作　　者：王甲南 卢涛 崔大炜 杨清波 赖承治[2] Jia-nan Wang;Tao Lu;Da-wei Cui;Qing-bo Yang;Cheng-zhi Lai(Department of General Surgery,the Fifth Affiliated Hospital of Zunyi Medical University(Zhuhai Hospital),Zhuhai,Guangdong 519000,China;Department of General Surgery,Ganzhou People’s Hospital,Ganzhou,Jiangxi 341000,China)

机构地区：[1]遵义医科大学第五附属(珠海)医院普外科,广东珠海519000 [2]赣州市人民医院普外科,江西赣州341000

出　　处：《中国内镜杂志》2020年第3期38-42,共5页China Journal of Endoscopy

摘　　要：目的探讨腹腔镜下全结肠系膜切除(CME)对右半结肠癌患者的手术效果及恢复情况的影响。方法选取2015年1月-2017年12月右半结肠癌患者70例,依据随机数字表分为腹腔镜组和开腹组,每组35例。腹腔镜组行腹腔镜下CME治疗,开腹组行开腹CME手术治疗,比较两组患者的治疗结果及恢复情况。结果两组患者术后皮质醇(COR)、促肾上腺皮质激素(ACTH)、肾上腺素(E)均明显高于术前,腹腔镜组术后COR、ACTH、E明显低于开腹组,差异均有统计学意义(P<0.05);两组患者的手术时间、淋巴结清扫数和复发率比较,差异均无统计学意义(P>0.05),腹腔镜组术中出血量、排气时间、下床时间、住院时间和并发症率明显少于开腹组,差异均有统计学意义(P<0.05)。结论腹腔镜下CME与开腹术式的治疗效果一致,且可有效减少患者的手术创伤、减轻应激反应,有利于减少患者术后并发症、缩短术后恢复时间,对于右半结肠癌患者应优先选择腹腔镜CME术式进行治疗。Objective To discuss the impact of laparoscopic complete mesocolic excision(CME) on the operation effect and recovery of patients underwent radical resection of right colon cancer. Methods 70 patients underwent radical resection of right colon cancer were selected from January 2015 to December 2017, according to the random number table method, they were divided into CME group and laparotomy group, 35 cases in each group. CME group was given laparoscopic CME treatment, and laparotomy group was given laparotomy treatment. The curative effect and recovery of the two groups were compared. Results The cortisol(COR), adrenocorticotropic hormone(ACTH) and epinephrine(E) in CME group and laparotomy group after operation were significantly higher than those before operation, the COR, ACTH and E in CME group after operation were significantly lower than those in laparotomy group, the difference was statistically significant(P < 0.05). There was no significant difference in operation time, lymph node dissection and recurrence rate between CME group and laparotomy group(P > 0.05), and the intraoperative bleeding volume, exhaust time, time out of bed, hospitalization time and complication rate in CME group were significantly lower than those in open group, the difference was statistically significant (P < 0.05). Conclusion Laparoscopic CME has the good therapeutic effect on patients underwent radical resection of right colon cancer, and it can effectively reduce the surgical trauma and stress response of patients, which is conducive to reducing postoperative complications and promoting their physical recovery, it’s worth for further clinical promotion.

关 键 词：腹腔镜下全结肠系膜切除 右半结肠癌根治术 疗效 术后恢复 

分 类 号：R735.35[医药卫生—肿瘤]