内镜黏膜下剥离术与腹腔镜根治术用于早期结直肠癌患者临床疗效对比  

Comparison of the clinical efficacy of endoscopic submucosal dissection and laparoscopic radical resection in patients with early-stage colorectal cancer

作　　者：郑舒丹 杨柳[1] ZHENG Shudan;YANG Liu(Department of Gastroenterology,Suzhou Municipal Hospital Affiliated to Nanjing Medical University,Suzhou 215000,China)

机构地区：[1]南京医科大学附属苏州市立医院本部消化内科,江苏苏州215000

出　　处：《中国肿瘤外科杂志》2025年第1期31-35,共5页Chinese Journal of Surgical Oncology

基　　金：江苏省自然科学基金项目(BK20210841)。

摘　　要：目的探究内镜黏膜下剥离术(ESD)与腹腔镜根治术用于早期结直肠癌患者临床疗效对比。方法回顾性选取苏州市立医院在2017年3月至2022年3月间收治的行手术治疗的结直肠癌患者115例。根据手术方法ESD手术和腹腔镜根治术分为ESD组(57例)和对照组(58例)。比较两组手术指标、肿瘤标志物、应激水平、疼痛程度、并发症及预后。结果观察组手术时间、卧床时间、首次排便时间及住院时间、失血量、并发症均少于对照组(P<0.05)。术后,两组细胞角蛋白19片段(CYFRA21-1)、糖类抗原72-4(CA72-4)、癌胚抗原(CEA)水平均较术前下降(P<0.05),但两组术后比较差异均无统计学意义(P>0.05)。术后,两组超氧化物歧化酶(SOD)、神经肽Y、皮质醇水平较术前升高,但观察组术后低于对照组(P<0.05)。术后24 h、48 h,两组视觉模拟评分法(VAS)评分均较术前逐渐升高,但观察组术后低于对照组(P<0.05)。结论ESD和腹腔镜根治术用于早期结直肠癌的临床治疗均有较好疗效,可有效降低肿瘤标志物,预后较好,但ESD较腹腔镜根治术所用手术时间短、失血量少、术后疼痛轻、并发症少,临床手术创伤较小,可促进术后快速恢复。Objective To explore the comparison of the clinical efficacy of endoscopic submucosal dissection and laparoscopic radical resection for early colorectal cancer patients with early-stage colorectal cancer.Methods A total of 115 patients with colorectal cancer who underwent surgical treatment in Suzhou Municipal Hospital from March 2017 to March 2022 were retrospectively selected.Divided into observation group(57 cases)and control group(58 cases)according to the surgical method,ESD and laparoscopic radical resection were performed,respectively.The surgical indicators,tumor markers,stress level,pain degree,complications and prognosis were compared between the two groups.Results The operation time,bed rest time,first defecation and hospital stay,blood loss and complications in the observation group were less than those in the control group(P<0.05).After operation,the levels of cytokeratin 19 fragment(CYFRA21-1),carbohydrate antigen 72-4(CA72-4)and Carcinoembryonic Antigen(CEA)in the two groups were lower than those before operation(P<0.05),but there was no stastistical differences between the two groups after operation(P>0.05).After operation,the levels of superoxide dismutase(SOD),neuropeptide Y and cortisol in the two groups were higher than those before operation,but those in the observation group were lower than those in the control group(P<0.05).At 24 and 48 hours after operation,the visual analogue scale(VAS)scores of the two groups gradually increased compared with those before operation,but the VAS scores of the observation group were lower than those of the control group(P<0.05).Conclusions ESD and laparoscopic radical resection for early colorectal cancer have good clinical efficacy in the clinical treatment of early colorectal cancer,and can effectively reduce the tumor markers,and have a better prognosis,but ESD has less operation time,less blood loss,less postoperative pain,less complications,less clinical surgical trauma than laparoscopic radical resection,which can promote rapid postoperative recovery.

关 键 词：腹腔镜根治术 内镜黏膜下剥离术 结直肠癌 肿瘤标志物 预后 

分 类 号：R735.34[医药卫生—肿瘤]