腹腔镜下完整结肠系膜切除结肠癌根治术的疗效及对患者应激反应的影响  

Effect of laparoscopic complete mesocolic excision on colon cancer and its influence on stress response

作　　者：孟涛 高正杰 侯栋 张俏 房祥杰[1] 朱绍辉[1] Meng Tao;Gao Zhengjie;Hou Dong;Zhang Qiao;Fang Xiangjie;Zhu Shaohui(Department of Gastrointestinal Surgery/Bariatrics,Metabolism and Hernia Surgery,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,China)

机构地区：[1]新乡医学院第一附属医院胃肠外科/减重代谢与疝外科,新乡453100

出　　处：《中国实用医刊》2025年第3期13-16,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨腹腔镜下完整结肠系膜切除结肠癌根治术(CME)的疗效及对患者应激反应的影响。方法队列研究。抽取2021年6月至2023年6月新乡医学院第一附属医院收治的结肠癌患者68例,按随机数字表法分为CME组和传统组,每组34例。CME组采用腹腔镜下CME治疗,传统组采用传统结肠癌根治术治疗。比较两组围术期指标、术后恢复情况、应激反应[肾上腺素(AD)、去甲肾上腺素(NA)、皮质醇(Cor)]及并发症发生率。结果CME组手术时间短于传统组,术中失血量少于传统组,淋巴结清扫数目多于传统组(P<0.05);CME组术后排气、排便、下床活动、住院时间短于传统组(P<0.05)。术后24 h,CME组AD、NA、Cor水平低于传统组(P<0.05)。CME组并发症发生率(2.94%,1/34)低于传统组(23.53%,8/34),P<0.05。结论腹腔镜下CME治疗结肠癌效果显著,能减少术中失血量,彻底清扫淋巴结,缩短手术时间,促进患者术后排气和下床活动,还能减轻机体应激反应,降低切口感染、肠梗阻等并发症发生率。Objective To investigate the effect of laparoscopic mesocolic excision(CME)on colon cancer,and to analyze its influence on stress response.MethodsA total of 68 patients with colon cancer treated in the First Affiliated Hospital of Xinxiang Medical University from June 2021 to June 2023 were selected for the cohort study,and they were divided into the CME group and the traditional group according to random number table method,with 34 cases in each group.The CME group was treated by laparoscopic CME,and the traditional group was treated by traditional radical resection of colon cancer.Perioperative indexes,postoperative recovery,stress response evaluated by adrenaline(AD),norepinephrine(NA)and cortisol(Cor),and incidence of complications were compared between the two groups.ResultsThe CME group had shorter operation duration,less intraoperative blood loss and more lymph nodes dissected compared with the traditional group(P<0.05);the time of postoperative exhaust,defecation,out-of-bed activities,and hospital stay of the CME group were shorter than those of the traditional group(P<0.05).At 24 hours after surgery,the levels of AD,NA,and Cor in the CME group were lower than those in the traditional group(P<0.05).The incidence of complications in the CME group(2.94%,1/34)was lower than that in the traditional group(23.53%,8/34),P<0.05.ConclusionsLaparoscopic CME has significant effects in the treatment of colon cancer,which can reduce intraoperative blood loss,thoroughly resect lymph nodes,shorten operation duration,promote postoperative exhaust and out-of-bed activities,reduce the stress response of the body,and decrease the incidence of complications such as incision infection and intestinal obstruction.

关 键 词：结肠癌 腹腔镜下完整结肠系膜切除结肠癌根治术 传统结肠癌根治术 应激反应 

分 类 号：R735.3[医药卫生—肿瘤]