全腹腔镜改良吻合用于左半结肠癌根治术的临床观察  

Clinical observation of total laparoscopic modified anastomosis for radical resection of left colon cancer

作　　者：邓先锐 郑磊[1] 杨春[2] 宋应寒[3] DENG Xianrui;ZHENG Lei;YANG Chun;SONG Yinghan(Gastrointestinal Surgery,Meishan People's Hospital of Sichuan,Meishan 620010,China)

机构地区：[1]眉山市人民医院胃肠外科,四川眉山620010 [2]四川省人民医院胃肠外科,610072 [3]四川大学华西医院胃肠外科,610041

出　　处：《临床肿瘤学杂志》2023年第6期537-540,共4页Chinese Clinical Oncology

摘　　要：目的 探索全腹腔镜改良吻合用于左半结肠癌根治术对患者胃肠功能、免疫功能及表皮生长因子(EGF)水平的影响。方法 收集2018年3月至2022年4月间收治的107例左半结肠癌根治术患者,均行全腹腔镜改良吻合术治疗,分析手术对患者胃肠功能、免疫功能及EGF水平的影响及并发症情况。结果 107例患者术后首次排气时间(21.13±1.76)h,总手术时间(137.46±17.46)min,切口长度(4.45±1.12)cm,共11例(10.28%)出现并发症。治疗后7d的CD4+、CD8+、NK、GAS、MTL、EGF水平含量改善情况均优于治疗前(P<0.05),而皮质醇、肾上腺素差异无统计学意义(P>0.05)。无并发症组合并发症组的患者在年龄、分化程度、Dukes分期、病理类型差异存在统计学意义(P<0.05)。结论 全腹腔镜改良吻合术在左半结肠癌患者中效果显著,可改善免疫功能和胃肠功能,但术后极易受年龄、病理类型、Dukes分期、分化程度影响,故需注重术前适应证排查,从而提高手术效果。Objective To investigate the effects of laparoscopic modified anastomosis on gastrointestinal function,immune function and epidermal growth factor(EGF)level in patients undergoing radical resection of left colon cancer.Methods One hundred and seven patients who underwent radical resection of left colon cancer from March 2018 to April 2022 were collected and treated with total laparoscopic modified anastomosis.The effects of surgery on gastrointestinal function,immune function,EGF level and complications were analyzed.Results In 107 patients,the first exhaust time was(21.13±1.76)h,the total operation time was(137.46±17.46)min,the incision length was(4.45±1.12)cm,and 11 patients(10.28%)had complications.The levels of CD4+,CD8+,NK,GAS,MTL and EGF were better than those before treatment 7 days after treatment(P<0.05),but there was no significant difference in cortisol and epinephrine(P>0.05).There were significant differences in age,degree of differentiation,Dukes stage and pathological type in the uncomplicated combined complication group(P<0.05).Conclusion Total laparoscopic modified anastomosis is effective in patients with left colon cancer,which can improve immune function and gastrointestinal function.However,it is highly affected by age,pathological type,Dukes stage and differentiation degree after surgery.Therefore,preoperative indication screening should be paid attention to to improve the surgical effect.

关 键 词：左半结肠癌 腹腔镜 胃肠功能 免疫功能 表皮生长因子 

分 类 号：R735.3[医药卫生—肿瘤]