无气腹腹腔镜结肠癌根治术对结肠癌患者胃肠功能、免疫功能和复发风险的影响  

Effect of gasless laparoscopic radical colon cancer surgery on gastrointestinal function,immune function and recurrence risk in patients with colon cancer

作　　者：岳晓香 徐华 杨晓贞 张巍巍 YUE Xiaoxiang;XU Hua;YANG Xiaozhen;ZHANG Weiwei(Department of Surgery,Xuchang Central Hospital,Xuchang 461000,He’nan,China;Department of Gastrointestinal Surgery,Xuchang Central Hospital,Xuchang 461000,He’nan,China)

机构地区：[1]许昌市中心医院外科,河南许昌4610000 [2]许昌市中心医院胃肠外科,河南许昌4610000

出　　处：《癌症进展》2022年第22期2370-2373,共4页Oncology Progress

摘　　要：目的探讨无气腹腹腔镜结肠癌根治术对结肠癌患者胃肠功能、免疫功能和复发风险的影响。方法依据手术方式的不同将106例结肠癌患者分为对照组和观察组,每组53例,对照组患者给予开腹手术,观察组患者给予无气腹腹腔镜结肠癌根治术。比较两组患者手术相关指标、胃肠功能指标(胃泌素、胃动素、抑胃肽)、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+),计算CD4^(+)/CD8^(+))和术后复发情况。结果观察组患者手术时间明显长于对照组,术中出血量明显少于对照组,术后肛门排气时间、肠鸣音恢复时间、住院时间均明显短于对照组,差异均有统计学意义(P<0.01)。术后3天,两组患者胃泌素、胃动素、抑胃肽水平均低于本组术前,但观察组患者胃泌素、胃动素、抑胃肽水平均高于对照组,差异均有统计学意义(P<0.05)。术后3天,两组患者CD3^(+)、CD4^(+)、CD8^(+)水平和CD4^(+)/CD8^(+)均低于本组术前,但观察组患者CD3^(+)、CD4^(+)、CD8^(+)水平和CD4^(+)/CD8^(+)均高于对照组,差异均有统计学意义(P<0.05)。观察组患者的1年复发率为5.66%,低于对照组患者的20.75%,差异有统计学意义(P<0.05)。结论无气腹腹腔镜结肠癌根治术对结肠癌患者的创伤较小,对患者免疫功能和胃肠功能的影响也较小,能够促进患者胃肠功能尽早恢复,缩短住院时间,改善预后。Objective To investigate the effect of gasless laparoscopic radical colon cancer surgery on gastrointestinal function,immune function and recurrence risk in patients with colon cancer.Method A total of 106 colon cancer patients were divided into control group and observation group according to different surgical methods,with 53 cases in each group.The patients in the control group were given laparotomy,and the patients in the observation group were given gasless laparoscopic radical colon cancer surgery.The surgery-related indexes,gastrointestinal function indexes(gastrin,motilin,gastric inhibitory peptide),immune function indexes(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),and postoperative recurrence were compared between the two groups.Result The operation time of the patients in the observation group was significantly longer than that in the control group,the amount of bleeding during the operation was significantly less than that in the control group,and the anal exhaust time,bowel sounds recovery time,and hospital stay after the operation were significantly shorter than those in the control group,the differences were statistically significant(P<0.01).Three days after the operation,the levels of gastrin,motilin,and gastric inhibitory peptide in the two groups were lower than those before the operation,the levels of these indicators in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Three days after the operation,the levels of CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)in the two groups were lower than those before the operation,the levels of the indexes in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The one-year recurrence rate of the observation group was 5.66%,which was lower than 20.75%of the control group,and the difference was statistically significant(P<0.05).Conclusion Gasless laparoscopic radical colon cancer surgery has less trauma to colon cancer pat

关 键 词：结肠癌 腹腔镜结肠癌根治术 复发风险 

分 类 号：R735.35[医药卫生—肿瘤]