肿瘤
ENGLISH ABSTRACT
腹腔镜下全系膜切除术治疗结直肠癌的临床研究
潘光明
曹权
杨海峰
王帮成
唐代清
作者及单位信息
·
DOI: 10.3760/cma.j.cn341190-20240314-00258
Clinical study on laparoscopic total mesorectal excision for the treatment of colorectal cancer
Pan Guangming
Cao Quan
Yang Haifeng
Wang Bangcheng
Tang Daiqing
Authors Info & Affiliations
Pan Guangming
Department of Tumor and Hepatobiliary Surgery, Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou Province, China
Cao Quan
Department of Tumor and Hepatobiliary Surgery, Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou Province, China
Yang Haifeng
Department of Tumor and Hepatobiliary Surgery, Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou Province, China
Wang Bangcheng
Department of Tumor and Hepatobiliary Surgery, Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou Province, China
Tang Daiqing
Department of Tumor and Hepatobiliary Surgery, Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou Province, China
·
DOI: 10.3760/cma.j.cn341190-20240314-00258
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摘要

目的探讨腹腔镜下全系膜切除术治疗结直肠癌的临床效果和优势。

方法选择2020年1月到2023年1月贵州医科大学第二附属医院接受治疗的结直肠癌患者82例开展前瞻性研究,通过随机数字表法进行分组,每组各41例,对照组开展常规开腹手术治疗,观察组给予腹腔镜下全系膜切除术治疗,比较两组疗效、临床指标及免疫功能指标。

结果观察组患者的手术时间[(1.98±0.31)h]、住院时间[(8.32±2.38)d]、肠道功能恢复时间[(2.15±0.34)d]和术中出血量[(112.35±12.66)mL]均短于、少于对照组的(2.46±0.32)h、(14.52±2.42)d、(3.25±0.15)d、(167.78±12.35)mL( t=6.90、11.70、18.95、20.07,均 P < 0.001);观察组的短期治疗有效率高于对照组( χ 2=4.10, P < 0.05);观察组免疫功能指标CD 4 +/CD 8 +比值[(1.78±0.54)]、免疫球蛋白A(Immunoglobulin A,IgA)[(3.87±0.73)g/L]和免疫球蛋白G(Immunoglobulin G,IgG)[(11.83±2.88)g/L]均优于对照组的(1.36±0.53)、(1.78±0.63)g/L、(6.37±2.45)g/L( t=3.55、13.88、9.25,均 P < 0.001);观察组患者的并发症发生率[2.44%(1/41)]低于对照组[19.51%(8/41)]( χ 2=4.49, P < 0.05)。

结论结直肠癌患者开展腹腔镜下全系膜切除术治疗具有恢复快、出血和并发症少等明显优势,相对于传统开腹手术效果更优。

结直肠肿瘤;腹腔镜;肠系膜;免疫;手术后并发症
ABSTRACT

ObjectiveTo investigate the clinical effects and advantages of laparoscopic total mesorectal excision in the treatment of colorectal cancer.

MethodsA total of 82 patients with colorectal cancer who received treatment at the Second Affiliated Hospital of Guizhou Medical University from January 2020 to January 2023 were selected for a prospective study. They were randomly assigned to two groups using a random number table, with 41 cases in each group. The control group underwent conventional laparotomy, while the observation group received laparoscopic total mesorectal excision. Clinical efficacy, clinical indicators, and immune function indicators were compared between the two groups.

ResultsThe operation time for patients in the observation group was (1.98 ± 0.31) hours, the length of hospital stay was (8.32 ± 2.38) days, the recovery time for bowel function was (2.15 ± 0.34) days, and the intraoperative blood loss was (112.35 ± 12.66) mL, all of which were shorter and lower than those in the control group [(2.46 ± 0.32) hours, (14.52 ± 2.42) days, (3.25 ± 0.15) days, and (167.78 ± 12.35) mL, t = 6.90, 11.70, 18.95, 20.07, all P < 0.001). The short-term response rate in the observation group was higher than that in the control group ( χ 2 = 4.10, P < 0.05). The immune function indicators in the observation group, including the CD4 +/CD8 + ratio (1.78 ± 0.54), immunoglobulin A [(3.87 ± 0.73) g/L], and immunoglobulin G [(11.83 ± 2.88) g/L], were all better than those in the control group [(1.36 ± 0.53), (1.78 ± 0.63) g/L, (6.37 ± 2.45) g/L, t = 3.55, 13.88, 9.25, all P < 0.001]. The incidence of complications in the observation group was 2.44% (1/41), which was significantly lower than that in the control group [19.51% (8/41), χ 2 = 4.49, P < 0.05].

ConclusionsLaparoscopic total mesorectal excision for patients with colorectal cancer has significant advantages, including faster recovery, less bleeding, and fewer complications, making it more superior to conventional laparotomy.

Colorectal neoplasms;Laparoscopes;Mesentery;Immunity;Postoperative complications
Pan Guangming, Email: mocdef.3ab6178gnimgp
引用本文

潘光明,曹权,杨海峰,等. 腹腔镜下全系膜切除术治疗结直肠癌的临床研究[J]. 中国基层医药,2025,32(03):331-335.

DOI:10.3760/cma.j.cn341190-20240314-00258

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结直肠癌也被称为大肠癌,是一种从结肠或直肠内壁的细胞开始发生恶性变化的肿瘤 1。在早期,患者可能没有任何症状,这使得早期发现变得困难。但随着病情的发展,症状会逐渐显现 2。典型症状有便血、持续的腹痛、腹部肿块、排便习惯的改变、不明原因的体质量下降以及持续感觉疲劳等。若肿瘤进一步扩散到其他器官或组织,还可能出现肠梗阻、肝功能异常等一系列严重并发症 3。对于结直肠癌患者来说,手术治疗通常是首选方案,其目的为尽可能地切除肿瘤组织,同时保留尽可能多的正常组织,以维持身体功能。根据肿瘤的位置、大小和扩散程度,手术的方式也会有所不同 4。在选择手术方案时,患者应充分了解各种手术方式的优缺点,并根据自身情况和医生的建议做出最佳决策 5。随着医学技术的进步,腹腔镜下全系膜切除术等微创手术方式的应用,使得手术创伤更小、恢复更快,进一步提高了患者的生活质量和预后 6。本研究对收治的82例结直肠癌患者展开了分组研究,结果如下。
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备注信息
A
潘光明,Email: mocdef.3ab6178gnimgp
B

潘光明:负责研究设计、数据分析和论文撰写;曹权:参与研究设计,负责数据收集和初步数据处理;杨海峰:参与研究设计,提供技术支持及指导,对文章内容进行审阅及修改;王帮成、唐代清:负责患者的筛选和随访,以及数据的收集

C
潘光明, 曹权, 杨海峰, 等. 腹腔镜下全系膜切除术治疗结直肠癌的临床研究[J]. 中国基层医药,2025,32(3):331-335. DOI:10.3760/cma.j.cn341190-20240314-00258.
D
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