单孔加一腹腔镜根治性手术治疗高位直肠癌和乙状结肠癌患者的临床效果  

Clinical Effect of Single-incision plus One-port Laparoscopic Surgery for Patients with High Rectal Cancer and Sigmoid Colon Cance

作　　者：吴泽坚 黄项武[1] 余加和[1] 林惠忠 宋伟伟 WU Zejian;HUANG Xiangwu;YU Jiahe;LIN Huizhong;SONG Weiwei(Affiliated Hospital of Putian University,Putian 351100,China;不详)

机构地区：[1]莆田学院附属医院,福建莆田351100

出　　处：《中外医学研究》2023年第14期1-4,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：福建省教育厅中青年课题项目(JAT_(2)00529)。

摘　　要：目的:分析单孔加一腹腔镜根治性手术(single-incision plus one-port laparoscopic surgery,SILS+1)治疗高位直肠癌和乙状结肠癌患者的临床效果。方法:选取2020年12月—2022年6月莆田学院附属医院收治的60例高位直肠癌和乙状结肠癌患者。根据随机数表法将其随机分为传统组(n=30)和SILS+1组(n=30)。SILS+1组接受SILS+1,传统组接受传统5孔法腹腔镜根治术。比较两组围手术期指标、肿瘤相关指标、术前和术后3 d炎症指标及并发症。结果:SILS+1组手术时间、术后住院时间、总切口长度均短于传统组,术中出血量少于传统组,术后首次排气时间、术后首次下地时间均早于传统组,术后3 d视觉模拟评分法(VAS)评分低于传统组,差异有统计学意义(P<0.05)。两组淋巴结清扫数目、肿瘤最大径、肿瘤远端及近端切缘距离比较差异无统计学意义(P>0.05)。SILS+1组肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)、C反应蛋白(CRP)水平均低于传统组,差异有统计学意义(P<0.05)。两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论:相比于传统腹腔镜手术,SILS+1应用于高位直肠癌和乙状结肠癌患者中,更有利于术后恢复,缩短手术时间,减少出血量,对机体的创伤较小。Objective:To analyze the clinical effect of single-incision plus one-port laparoscopic surgery(SILS+1)in the treatment of high rectal cancer and sigmoid colon cancer.Method:From December 2020 to June 2022,60 patients with high rectal cancer and sigmoid colon cancer were selected from the Affiliated Hospital of Putian University.According to the random number table method,they were randomly divided into the traditional group(n=30)and the SILS+1 group(n=30).The SILS+1 group received SILS+1,while the traditional group received traditional 5-hole laparoscopic radical surgery.The perioperative indicators,tumor related indicators,preoperative and postoperative at 3 d inflammatory indicators,and complications were compared between two groups.Result:The surgical time,postoperative hospitalization time,and total incision length of the SILS+1 group were shorter than those of the traditional group,the intraoperative blood loss was less than that in the traditional group,the first postoperative exhaust time and first postoperative landing time were earlier than those of the traditional group,and the visual analogue scale(VAS)score was lower than that of the traditional group 3 d after surgery,the differences were statistically significant(P<0.05).There were no statistically significant differences in the number of lymph node dissection,maximum tumor diameter,and distance between the distal and proximal tumor margins between the two groups(P>0.05).The levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP)in SILS+1 group were lower than those of the traditional group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Compared with traditional laparoscopic surgery,SILS+1 is more beneficial to postoperative recovery,shorten the operation time,reduce the amount of bleeding,and have less trauma to the body in patients with high rectal cancer and sigmo

关 键 词：单孔加一腹腔镜手术 高位直肠癌 乙状结肠癌 

分 类 号：R735.37[医药卫生—肿瘤] R735.35[医药卫生—临床医学]