| 吴金东,江晓晖,朱汉达,张小磊,李国兴.联合入路翻页式腹腔镜辅助右半结肠癌根治术与开腹根治术术后近期效果比较[J].,2022,(3):548-552 |
| 联合入路翻页式腹腔镜辅助右半结肠癌根治术与开腹根治术术后近期效果比较 |
| Comparison of Short-term Results after Combined Approach and Page-turning Laparoscopic-assisted Radical Resection of Right Colon Cancer and Open Radical Resection |
| 投稿时间：2021-06-03 修订日期：2021-06-27 |
| DOI：10.13241/j.cnki.pmb.2022.03.031 |
| 中文关键词: 腹腔镜 入路翻页式 右半结肠癌 术后恢复 开放手术 |
| 英文关键词: Laparoscopy Page-turning approach Right colon cancer Postoperative recovery Open surgery |
| 基金项目:江苏省卫计委预防医学基金项目（Y2018038） |
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| 中文摘要: |
| 摘要 目的：探讨联合入路翻页式腹腔镜辅助右半结肠癌根治术与开腹根治术术后近期效果比较。方法：选取2019年4月-2021年3月在南通大学附属肿瘤医院经CT和电子肠镜确诊的右伴结肠癌患者，所有患者均选择根治性右半结肠切除术（D2）。最后纳入研究对象77例，其中男性患者39例，女性患者38例，年龄37~75岁。根据手术方案将患者分为联合入路翻页式腹腔镜辅助手术40例，并命名为观察组，剩余37例行开放式根治术，为对照组。所有患者均提供了知情同意书。根据临床资料收集患者一般信息。记录围手术期结局为开腹手术或腹腔镜手术的手术时间，失血量，肛门排气时间，液体饮食时间，住院时间和30天之内的并发症和死亡率等。通过蛋白印迹分析患者术后7天血清内Polo样激酶（Polo-like Kinase 1，Plk1）、胸苷激酶1（Thymidine Kinase 1，TK1）、X连锁的凋亡蛋白抑制剂（X-linked inhibitor of apoptosis protein，XIAP）的活力。结果：两组患者一般资料比较无差异（P>0.05）。观察组较对照组的手术运行时间缩短，失血量减少，血管危险因素病发率降低（P<0.05），淋巴结获得量两组比较无差异（P>0.05）。观察组较对照组的住院时间、第一次肛门排气时间、输液天数和胃肠功能恢复时间缩短（P<0.05）。观察组较对照组在吻合口漏、乳糜漏、术后腹腔出血和麻痹性肠梗阻等不良发生率比较无差异（P>0.05），观察组较对照组的整体不良发生率升高（P<0.05）。观察组较对照组的Plk1、TK1、XIAP的蛋白表达降低（P<0.05）。结论：联合入路翻页式腹腔镜辅助右半结肠癌安全可行，且具有手术难度低,缩短手术时间，减少术中出血以及加快术后康复的优势。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the short-term effect comparison between combined approach and page-turning laparoscopic-assisted radical resection of right colon cancer and open radical resection. Methods: Patients with right colon cancer diagnosed by CT and electronic enteroscopy in the Affiliated Tumor Hospital of Nantong University from April 2019 to March 2021 were selected. All patients were selected for radical right hemicolectomy (D2). Finally, 77 subjects were included in the study, including 39 male patients and 38 female patients, aged 37-75 years old. According to the surgical plan, the patients were divided into 40 cases of combined approach and page-turning laparoscopic assisted surgery and named the observation group. The remaining 37 cases underwent open radical surgery and served as the control group. All patients provided informed consent. Collect general patient information based on clinical data. The perioperative outcome was recorded as the operation time of laparotomy or laparoscopic surgery, blood loss, anal exhaust time, fluid diet time, hospital stay, and complications and mortality within 30 days. Polo-like kinase (Polo-like Kinase 1, Plk1), Thymidine Kinase 1 (TK1), X-linked inhibitor of apoptosis (X-linked inhibitor of apoptosis) were analyzed by western blotting in patients' serum 7 days after surgery. protein, XIAP) vitality. Results: There was no difference in general information between the two groups of patients (P>0.05). Compared with the control group, the observation group had shorter operation time, less blood loss, and lower incidence of vascular risk factors (P<0.05). There was no difference in the amount of lymph node acquisition between the two groups (P>0.05). Compared with the control group, the observation group had shorter hospital stay, first anal exhaust time, infusion days and gastrointestinal function recovery time(P<0.05). Compared with the control group, the observation group had no difference in the incidence of anastomotic leakage, chyle leakage, postoperative abdominal bleeding and paralytic intestinal obstruction(P>0.05), and the observation group had a higher overall incidence of adverse events than the control group(P<0.05). The protein expressions of Plk1, TK1, and XIAP in the observation group were lower than those in the control group(P<0.05). Conclusion: The combined approach of page-turning laparoscopic assisted right colon cancer is safe and feasible, and has low surgical difficulty, shortens the operation time, and reduces the operation time. The advantages of bleeding and speeding up postoperative recovery. |
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