首页|腹腔镜下保留左结肠动脉直肠癌根治术对直肠癌患者围手术期指标及术后恢复的影响

腹腔镜下保留左结肠动脉直肠癌根治术对直肠癌患者围手术期指标及术后恢复的影响

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目的 探讨腹腔镜下保留左结肠动脉(left colic artery,LCA)直肠癌根治术在直肠癌患者中的应用效果.方法 回顾性选取2020年1月—2023年5月湄潭县中西医结合医院收治的84例腹腔镜直肠癌根治术患者的临床资料,根据是否保留LCA分为两组,各42例.对照组不保留LCA,观察组保留LCA.对比两组患者围手术期指标、术后恢复情况、并发症发生率及免疫功能.结果 两组患者围手术期指标及术后恢复情况比较,差异无统计学意义(P均>0.05).观察组并发症总发生率为4.76%(2/42),低于对照组的19.05%(8/42),差异有统计学意义(χ2=4.087,P=0.043).术后 24 h,观察组CD3+为(60.77±4.36)%、CD4+为(45.75±3.25)%、CD4+/CD8+为(1.75±0.26),均高于对照组的(55.68±4.17)%、(40.47±4.14)%、(1.43±0.21);观察组的CD8+为(26.02±2.25)%,低于对照组的(28.47±2.43)%,差异有统计学意义(t=5.468、6.501、6.205、4.795,P均<0.001).结论 腹腔镜下保留LCA直肠癌根治术可减少吻合口瘘等并发症的发生,促进术后免疫功能恢复.
Effect of Laparoscopic Preservation of Left Colic Artery Rectal Cancer Radical Resection on Perioperative Index and Postoperative Recovery in Patients with Rectal Cancer
Objective To explore the effect of laparoscopic preservation of left colic artery(LCA)for rectal cancer in patients with rectal cancer.Methods The clinical data of 84 patients with laparoscopic radical resection of rectal can-cer admitted to Meitan County Hospital of Integrated Traditional Chinese and Western Medicine from January 2020 to May 2023 were retrospectively selected,and were divided into two groups according to whether LCA was retained,with 42 cases in each group.The control group did not retain LCA,and the observation group retained LCA.Periopera-tive indexes,postoperative recovery,complication rate and immune function were compared between the two groups.Results There was no significant difference in perioperative indexes and postoperative recovery between the two groups(both P>0.05).The total incidence of complications in the observation group was 4.76%(2/42),lower than that in the control group 19.05%(8/42),the difference was statistically significant(χ2=4.087,P=0.043).At 24 h after op-eration,CD3+,CD4+and CD4+/CD8+in observation group were(60.77±4.36)%,(45.75±3.25)%and(1.75±0.26),which were higher than those in control group(55.68±4.17)%,(40.47±4.14)%and(1.43±0.21),CD8+in observation group was(26.02±2.25)%,lower than the control group(28.47±2.43)%,the differences were statistically significant(t=5.468,6.501,6.205,4.795,all P<0.001).Conclusion Laparoscopic LCA resection can reduce the incidence of compli-cations such as anastomotic fistula and promote the recovery of postoperative immune function.

Rectal cancerLaparoscopic radical resecation of rectal cancerLeft colic arteryComplicationsImmunologic function

柏爱华

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湄潭县中西医结合医院外科,贵州 遵义 564100

直肠癌 腹腔镜直肠癌根治术 左结肠动脉 并发症 免疫功能

2024

中外医疗
卫生部医院管理研究所 二十一世纪联合创新医药科学研究院

中外医疗

影响因子:0.909
ISSN:1674-0742
年,卷(期):2024.43(31)