摘要
目的探究经自然腔道取标本手术在腹腔镜下直肠癌手术中的应用疗效。方法选取2018年5月至2019年5月本院收治的直肠癌患者36例,按照就诊顺序奇偶性分为观察组和对照组,各18例。观察组采用经自然腔道取标本手术(NOSES)治疗,对照组采用传统腹腔镜直肠癌根治术治疗。比较两组免疫功能指标、临床指标及手术前后应激因子情况。结果两组术前免疫功能指标(lgG、lgM、lgA)比较差异无统计学意义,术后观察组免疫功能指标均高于对照组,差异有统计学意义(P<0.05);两组术中出血量、淋巴清扫数目、手术时间比较差异无统计学意义,术后观察组排气时间短于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为11.11%,低于对照组的72.22%,比较差异有统计学意义(P<0.05);术前两组ET、sVCAM-1、E-选择素、MMP-9水平比较差异无统计学意义,术后观察组各项指标水平均低于对照组,差异有统计学意义(P<0.05)。结论采用经自然腔道取出标本手术治疗直肠癌患者,可显著改善患者生活质量,对机体免疫功能影响较小,能减少应激因子的表达,安全性高,具有临床应用价值。
Objective To explore the effect of the operation of taking specimens through natural cavity in laparoscopic rectal cancer surgery.Methods 36 patients with rectal cancer who were admitted to our hospital from May 2018 to May 2019 were selected and they were divided into observation group and control group according to the order of visits,with 18 cases in each group.The observation group was treated with natural cavity sampling(NOSES),and the control group was treated with traditional laparoscopic radical surgery for rectal cancer.The immune function indexes,clinical indexes and stress factors before and after surgery were compared between the two groups.Results The preoperative immune function indexes(lgG,lgM,lgA)of the two groups were not statistically significant.The postoperative observation group immune function indexes were higher than the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in intraoperative blood loss,number of lymphatic dissections,and operation time between the two groups.The postoperative observation group had a shorter exhaust time than the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the observation group was 11.11%,lower than 72.22%of the control group,the difference was statistically significant(P<0.05).The levels of ET,sVCAM-1,E-selectin,and MMP-9 were not statistically different between the two groups before surgery.The index level inthe observation groupwas lower than that of the control group after surgery,and the difference was statistically significant(P<0.05).Conclusion The operation of removing the specimen through the natural cavity to treat patients with rectal cancer can significantly improve the patient's quality of life,have little effect on the body's immune function,reduce the expression of stress factors,have high safety,and have clinical application value.
作者
刘九思
Liu Jiusi(Department of General Surgery,Central People's Hospital of Ji'an,Jiangxi Province,Ji'an,Jiangxi,343000,China)
出处
《当代医学》
2020年第27期13-15,共3页
Contemporary Medicine
关键词
直肠癌
自然腔道取标本手术
腹腔镜
Rectal cancer
Surgery for natural cavity sampling
Laparoscopy
