改良横向入路法与尾侧入路法腹腔镜根治术治疗结肠癌的疗效对比  

Comparison of curative effect of modified lateral approach and caudal approach in laparoscopic radical operation for colon cancer

作　　者：赵志铭 李晓静 李立威[1] Zhao Zhiming;Li Xiaojing;Li Liwei(Department of Second General Surgery,Suihua City First Hospital,Suihua 152000,China;Department of Sixth Neurology,Suihua City First Hospital,Suihua 152000,China)

机构地区：[1]绥化市第一医院普外二科,绥化152000 [2]绥化市第一医院神经六科,绥化152000

出　　处：《中国医师进修杂志》2024年第10期927-931,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的分析改良横向入路法与尾侧入路法腹腔镜根治术治疗结肠癌的疗效对比。方法回顾性选取2020年1月至2023年1月在绥化市第一医院行结肠癌手术的100例患者为研究对象,按照采用手术方式的不同分为两组,49例行尾侧入路法腹腔镜根治术的患者为对照组,51例行改良横向入路法腹腔镜根治术的患者为研究组。比较两组患者临床相关手术指标、肿瘤标志物、胃肠功能指标及应激反应指标水平,比较两组并发症发生情况。结果研究组手术时间、术中出血量、淋巴结清扫数量、住院时间低于对照组[(175.48±16.87)min比(203.12±15.41)min、(104.63±13.47)ml比(118.07±15.98)ml、(18.72±1.67)个比(19.96±2.01)个、(9.13±1.64)d比(13.48±2.19)d],差异有统计学意义(P<0.05);研究组术后癌抗原19-9、癌胚抗原水平低于对照组[(37.16±9.24)kU/L比(42.14±10.23)kU/L、(18.27±6.76)μg/L比(22.45±8.45)μg/L],差异有统计学意义(P<0.05)。研究组术后排气时间、恢复进食时间、肠鸣音恢复时间低于对照组[(40.47±5.03)h比(59.73±6.16)h、(70.58±8.24)h比(94.57±10.42)h、(21.79±3.68)h比(35.06±4.27)h],差异有统计学意义(P<0.05);研究组术后促肾上腺皮质激素、醛固酮、皮质醇水平低于对照组[(16.95±1.91)ng/L比(21.52±2.53)ng/L、(135.00±15.24)ng/L比(151.80±15.72)ng/L、(220.03±21.40)μg/L比(239.94±24.37)μg/L],差异有统计学意义(P<0.05)。研究组手术并发症发生率低于对照组[5.88%(3/51)比22.45%(11/49)],差异有统计学意义(χ^(2)=11.60,P<0.05)。结论改良横向入路法腹腔镜根治术的治疗效果优于尾侧入路法腹腔镜根治术。Objective To compare the curative effect of modified lateral approach and caudal approach in laparoscopic radical operation for colon cancer.Methods A total of 100 patients undergoing colon cancer surgery in the Suihua City First Hospital from January 2020 to January 2023 were retrospectively selected as the study objects,and they were divided into two groups according to different surgical methods,49 patients undergoing laparoscopic radical resection by caudal approach were in the control group,and 51 patients undergoing laparoscopic radical resection by modified lateral approach were in the study group.The levels of clinical related surgical indexes,tumor markers,gastrointestinal function indexes and stress response indexes were compared between the two groups,and the incidence of complications was compared between the two groups.Results The operation time,intraoperative blood loss,number of lymph node dissection and hospital stay in the study group were lower than those in the control group:(175.48±16.87)min vs.(203.12±15.41)min,(104.63±13.47)ml vs.(118.07±15.98)ml,(18.72±1.67)nodes vs.(19.96±2.01)nodes,(9.13±1.64)d vs.(13.48±2.19)d,there were statistical differences(P<0.05).After operation,the levels of cancer antigen 19-9(CA199)and carcinoembryonic antigen(CEA)in the study group were lower than those in the control group:(37.16±9.24)kU/L vs.(42.14±10.23)kU/L,(18.27±6.76)μg/L vs.(22.45±8.45)μg/L,there were statistical differences(P<0.05).The postoperative exhaust time,feeding time and bowel sound recovery time in the study group were shorter than those in the control group:(40.47±5.03)h vs.(59.73±6.16)h,(70.58±8.24)h vs.(94.57±10.42)h,(21.79±3.68)h vs.(35.06±4.27)h,there were statistical differences(P<0.05).After operation,the levels of adrenocorticotropin(ACTH),aldosterone(ALD)and cortisol(Cor)in the study group were lower than those in the control group:(16.95±1.91)ng/L vs.(21.52±2.53)ng/L,(135.00±15.24)ng/L vs.(151.80±15.72)ng/L,(220.03±21.40)μg/L vs.(239.94±24.37)μg/L,there wer

关 键 词：结肠肿瘤 腹腔镜 改良横向入路法 尾侧入路法 

分 类 号：R735.35[医药卫生—肿瘤]