腹腔镜下经自然腔道取标本手术对结直肠癌患者创伤应激反应及脱落肿瘤细胞种植播散的影响  

Effects of laparoscopic natural orifice specimen extraction surgery on traumatic stress response and implantation and dissemination of exfoliated tumor cells in patients with colorectal cancer

作　　者：肖虎 王甜甜 XIAO Hu;WANG Tiantian(Ankang Central Hospital,Ankang 725000;Ankang Hospital of Traditional Chinese Medicine,Ankang 725000,China)

机构地区：[1]安康市中心医院,陕西安康725000 [2]安康市中医医院,陕西安康725000

出　　处：《临床医学研究与实践》2023年第32期61-64,共4页Clinical Research and Practice

摘　　要：目的探讨腹腔镜下经自然腔道取标本手术对结直肠癌患者创伤应激反应及脱落肿瘤细胞种植播散的影响。方法选取2019年1月至2022年1月收治的60例结直肠癌患者,根据治疗方式不同将其分为对照组和观察组,各30例。对照组采用常规腹腔镜手术治疗,观察组采用腹腔镜下经自然腔道取标本手术治疗。比较两组的治疗效果。结果术后1 d,观察组的皮质醇(Cor)、醛固酮(ALD)、肾上腺素(E)水平低于对照组,差异具有统计学意义(P<0.05)。手术开始时、手术结束前,两组的腹腔灌洗液肿瘤细胞比较,差异无统计学意义(P>0.05);吻合前、吻合后,两组的肠腔灌洗液肿瘤细胞比较,差异无统计学意义(P>0.05)。术后1 d,观察组的免疫球蛋白A(IgA)、免疫球蛋白M(IgM)水平高于对照组(P<0.05)。结论腹腔镜下经自然腔道取标本手术有助于减轻结直肠癌患者创伤应激反应,改善免疫功能,在脱落肿瘤细胞种植播散上与传统腹腔镜手术相比无明显差异。Objective To investigate the effects of laparoscopic natural orifice specimen extraction surgery on traumatic stress response and implantation and dissemination of exfoliated tumor cells in patients with colorectal cancer.Methods A total of 60 patients with colorectal cancer admitted from January 2019 to January 2022 were selected and divided into control group and observation group according to different treatment methods,with 30 cases in each group.The control group was treated with conventional laparoscopic surgery,and the observation group was treated with laparoscopic natural orifice specimen extraction surgery.The therapeutic effects of the two groups were compared.Results At 1 d after operation,the levels of cortisol(Cor),aldosterone(ALD)and epinephrine(E)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).At the beginning of the operation and before the end of the operation,there was no significant difference in tumor cells in peritoneal lavage fluid between the two groups(P>0.05);before and after anastomosis,there was no significant difference in tumor cells in intestinal lavage fluid between the two groups(P>0.05).At 1 d after operation,the levels of immunoglobulin A(IgA)and immunoglobulin M(IgM)in the observation group were higher than those in the control group(P<0.05).Conclusion Laparoscopic natural orifice specimen extraction surgery is helpful to reduce the traumatic stress response and improve the immune function of patients with colorectal cancer,and there is no significant difference in the implantation and dissemination of exfoliated tumor cells compared with traditional laparoscopic surgery.

关 键 词：腹腔镜 经自然腔道取标本手术 结直肠癌 创伤应激反应 脱落肿瘤细胞种植播散 

分 类 号：R735.34[医药卫生—肿瘤]