腹腔镜根治术不同入路方式对左半结肠癌患者炎症因子及应激指标的影响
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Effects of different laparoscopic surgical approaches on inflammatory fac-tors and stress indicators in left-sided colon cancer patients
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    目的:分析腹腔镜根治术网膜囊入路和中间入路不同入路方式对左半结肠癌患者炎症因子及应激指标的影响。方法:选取拟行腹腔镜根治术的80例左半结肠癌患者作为研究对象,按照不同手术入路方式分为研究组(网膜囊入路)和对照组(中间入路),每组各40例。对比两组患者的手术相关指标和术后恢复情况,分别检测患者术前、术后3 d的血清炎症因子及应激指标。结果:两组患者的手术时间、淋巴结清扫数量相比,差异均无统计学意义(P>0.05),但研究组的腹腔镜游离时间和术后引流量均低于对照组(P<0.05);两组患者的首次排气时间、首次排便时间、进食时间相比,差异均无统计学意义(P>0.05),但研究组的住院时间低于对照组(P<0.05);两组患者术前炎症因子和应激水平相比,差异均无统计学意义(P>0.05);两组患者术后的hs-CRP、IL-6、TNF-α、去甲肾上腺素、肾上腺素、皮质醇水平均高于术前(P<0.05),且研究组低于对照组(P<0.05)。结论:不同入路方式下腹腔镜根治术对左半结肠癌患者的影响不同,相较于中间入路,网膜囊入路可有效缩短患者的腹腔镜游离时间和住院时间,且对患者炎症因子和应激指标的影响更小,有利于患者术后的早期康复。

    Abstract:

    Objective:To analyze the effects of different approaches of omental sac approach and intermediate approach in lapa-roscopic radical resection on inflammatory factors and stressindicatorsin patients with left colon cancer.Methods:80 patients with left-sided colon cancer scheduled for laparoscopic radical surgery were selected as the study subjects.According to different surgical approa-ches,they were divided into a study group(omental bursa approach)and a control group(intermediate approach),with 40 cases in each group.The surgical-related indicators and postoperative recovery of the two groups were compared,and serum inflammatory factors and stress indicators were measured preoperatively and on the third postoperative day.Results:There were no statistically significant differences in surgical time and number of lymph nodes dissected between the two groups(P>0.05),but the study group had lower laparoscopic free time and postoperative drainage volume compared to the control group(P<0.05).There were no statistically signifi-cant differences in first exhaust time,first defecation time,and feeding time between the two groups(P>0.05),but the study group had a shorter hospital stay compared to the control group(P<0.05).There were no statistically significant differences in inflammatory factors and stress levels before surgery between the two groups(P>0.05),and the levels of hs-CRP,IL-6,TNF-α,norepinephrine,epi-nephrine,and cortisol in both groups were higher after surgery compared to before surgery(P<0.05),and the study group was lower than the control group(P<0.05).Conclusion:Laparoscopic radical surgery with different approaches has different effects on patients with left colon cancer.Compared with the middle approach,omental sac approach can effectively shorten the laparoscopic free time and hospital stay of patients,and has less impact on inflammatory factors and stressindicatorsof patients,which is conducive to early postop-erative rehabilitation of patients.

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张云;赵冬雨;李頔;王晓娜;.腹腔镜根治术不同入路方式对左半结肠癌患者炎症因子及应激指标的影响[J].川北医学院学报,2025,40(6):795-798.

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  • 在线发布日期: 2025-07-09
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