临床医学研究与实践2024,Vol.9Issue(4) :82-85.DOI:10.19347/j.cnki.2096-1413.202404019

头侧入路与中间入路在改良腹腔镜辅助右半结肠癌D3根治术中的应用效果比较

Comparison of application effect of cephalic approach and intermediate approach in modified laparoscopic-assisted D3 radical resection of right colon cancer

田红刚 赵冲 郝婷婷
临床医学研究与实践2024,Vol.9Issue(4) :82-85.DOI:10.19347/j.cnki.2096-1413.202404019

头侧入路与中间入路在改良腹腔镜辅助右半结肠癌D3根治术中的应用效果比较

Comparison of application effect of cephalic approach and intermediate approach in modified laparoscopic-assisted D3 radical resection of right colon cancer

田红刚 1赵冲 2郝婷婷3
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作者信息

  • 1. 西安国际医学中心医院,陕西 西安,710100
  • 2. 西安凤城医院,陕西 西安,710018
  • 3. 延安大学附属医院,陕西 延安,716000
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摘要

目的 比较头侧入路与中间入路在改良腹腔镜辅助右半结肠癌D3 根治术中的应用效果.方法 选取2019年6月至2022年6月收治的100例行改良腹腔镜辅助右半结肠癌D3根治术患者为研究对象,根据入路方式不同将其分为A组和B组,各 50 例.A组采用头侧入路,B组采用中间入路.比较两组的治疗效果.结果 A组的中央淋巴结清扫时间、总手术时间短于B组,术中失血量少于B组,血管损伤发生率低于B组(P<0.05).术后1d,两组的醛固酮(ALD)、皮质醇(Cor)、促肾上腺皮质激素(ACTH)水平明显升高,但A组低于B组(P<0.05).术后 7d,两组的Polo样激酶 1(PLk1)、胸苷激酶 1(TK1)、Livin水平均降低,且A组低于B组(P<0.05).结论 头侧入路与中间入路在改良腹腔镜辅助右半结肠癌D3根治术中均能取得较好的效果,但头侧入路有助于缩短手术时间,减少失血量,降低血管损伤发生率,减轻机体应激反应,也能下调癌活力,值得推广.

Abstract

Objective To compare the application effect of cephalic approach and intermediate approach in modified laparoscopic-assisted D3 radical resection of right colon cancer.Methods A total of 100 patients who underwent modified laparoscopic-assisted D3 radical resection of right colon cancer from June 2019 to June 2022 were selected as the research objects.According to the different approaches,the patients were divided into group A and group B,with 50 cases in each group.The group A was treated with cephalic approach,and the group B was treated with intermediate approach.The therapeutic effects of the two groups were compared.Results The central lymph node dissection time and total operation time of the group A were shorter than those of the group B,the intraoperative blood loss was less than that of the group B,and the incidence of vascular injury was lower than that of the group B(P<0.05).At 1 d after operation,the levels of aldosterone(ALD),cortisol(Cor)and adrenocorticotropic hormone(ACTH)in the two groups increased significantly,but those in the group A were lower than the group B(P<0.05).At 7 d after operation,the levels of polo-like kinase 1(PLk1),thymidine kinase 1(TK1)and Livin in the two groups decreased,and those in the group A were lower than the group B(P<0.05).Conclusion Both the cephalic approach and the intermediate approach can achieve good results in the modified laparoscopic-assisted D3 radical resection of right colon cancer,but the cephalic approach can help shorten the operation time,decrease blood loss,decrease the incidence of vascular injury,reduce the body's stress response,and down-regulate cancer viability,which is worthy of promotion.

关键词

头侧入路/中间入路/腹腔镜/右半结肠癌/D3根治术

Key words

cephalic approach/intermediate approach/laparoscopy/right colon cancer/D3 radical resection

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基金项目

延安市科技创新研发平台项目(延市科发[2021]22号)

出版年

2024
临床医学研究与实践

临床医学研究与实践

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