幽门下淋巴结清扫在腹腔镜右半结肠癌根治术中的临床应用  

Clinical application of subpyloric lymph node dissection in laparoscopic radical resection of right colon cancer

作　　者：朱融慧 周兴舰[1] 宋俊 郭朝阳[1] 秦章禄[1] ZHU Ronghui;ZHOUXingjian;SONGJun;GUOChaoyang;QIN Zhanglu(Three DepartmentofGeneral,PingxiangPeople'sHospital,Pingxiang,Jiangxi,337000,China)

机构地区：[1]萍乡市人民医院普三科,江西萍乡337000

出　　处：《当代医学》2023年第28期165-168,共4页Contemporary Medicine

基　　金：江西省卫生健康委科技计划项目(SKJP220200294)。

摘　　要：目的探讨幽门下淋巴结清扫在腹腔镜右半结肠癌根治术中的应用效果。方法选取2019年1月至2022年2月萍乡市人民医院收治的50例右半结肠癌患者作为研究对象,根据疾病类型分为对照组与观察组,每组25例。对照组为非横结肠近肝曲的右半结肠癌患者,观察组为横结肠近肝曲的右半结肠癌患者,两组均采用幽门下淋巴结清扫术治疗,比较两组围手术期指标、肿瘤标志物、淋巴结阳性率及术后并发症发生率。结果观察组手术时间、中央淋巴结清扫时间均长于对照组,术中出血量、淋巴结清扫数及幽门下区淋巴结数量均多于对照组,差异有统计学意义(P<0.05)。术后7d,两组血管内皮生长因子(VEGF)、结肠癌特异性抗原2(CCSA-2)及可溶性细胞黏附分子-1(sICAM-1)水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组术后淋巴结阳性率低于对照组,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。结论幽门下淋巴结清扫用于腹腔镜右半结肠癌根治术中手术创伤较小,能改善患者肿瘤标志物水平,降低淋巴结阳性率,且未增加术后并发症发生率,值得临床推广应用。Objective To explore the application effect of subpyloric lymph node dissection in laparoscopic radical resection of right colon can-cer.Methods 50 patients with right half colon cancer treated in Pingxiang People's Hospital from January 2019 to February 2022 were selected as the research subjects,and they were divided into the control group and the observation group according to disease type,with 25 cases in each group.The control group was right hemicolonic carcinoma patients without transverse colon and the experimental group was right hemicolonic carcinoma patients with transverse colon and liver curvature.Both groups were treated with subpyloric lymph node dissection.The perioperative indexes,tumor markers,positive rate of lymph nodes and postoperative complications were compared between the two groups.Results The operative time and cen-tral lymph node dissection time in the experimental group were longer than those in the control group,and the intraoperative blood loss,the number of lymph node dissection and the number of lymph nodes in the subpyloric region were higher than those in the control group,and the differences were statistically significant(P<0.05).At 7 d after surgery,the levels of vascular endothelial growth factor(VEGF),colon cancer specific antigen 2(CCSA-2)and soluble cell adhesion molecule-1(sICAM-1)of the two groups were lower than before surgery,and the experimental was lower than the control group,the differences were statistically significant(P<0.05).The positive rate of lymph nodes in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups.Conclusion Subpyloric lymph node dissection for laparoscopic radical resection of right colon cancer has less surgical trauma,can improve the level of tumor markers,reduce the positive rate of lymph nodes,and does not increase the incidence of postop-erative complications,which is worth

关 键 词：幽门下淋巴结清扫 腹腔镜右半结肠癌根治术 手术创伤 肿瘤标志物 围手术期指标 

分 类 号：R735.35[医药卫生—肿瘤]