探讨结直肠癌合并肠梗阻腹腔镜根治术的近期疗效及对炎性因子的影响,以改善临床治疗效果。
评估了2019年1月至2020年12月在我院治疗的肠梗阻结直肠癌患者(n=167)的数据。将患者分为腹腔镜结直肠癌根治术组(LRRCC,n=90)和开放手术组(OP,n=77)。治疗前和1日,3rd,5th,治疗后第7天和第15天,他们的血清疼痛因子水平,神经肽Y,血清生化分析仪测定前列腺素E2和神经生长因子,他们的炎症因子水平,包括C反应蛋白,白细胞介素6(IL-6),ELISA法检测IL-8和肿瘤坏死因子-α,和它们的CD3+的数量,通过流式细胞术测量CD4+和CD8+T细胞亚群。在治疗前和治疗后4周和8周评估肛门直肠运动。使用Kaplan-Meier方法评估生存率。
在1号,3rd,5th,治疗后第7天和第15天,与OP组相比,LRRCC组血清疼痛因子水平较低,炎症因子和CD8+T淋巴细胞,而他们的CD3+和CD4+T淋巴细胞亚群的数量显著增加。Further,LRRCC组并发症较少,生存率明显较高,显示出比OP组更好的疗效。
对于结直肠癌合并肠梗阻患者,腹腔镜根治术是有效的,取得了优于开腹手术的疗效。
To investigate the short-term efficacy of laparoscopic radical resection for colorectal cancer with bowel obstruction and the effects of the surgery on inflammatory factors for improving the clinical treatment of the condition.
The data of colorectal cancer patients presenting bowel obstruction (n = 167) treated at our hospital from January 2019 to December 2020 were assessed. The patients were divided into a laparoscopic radical resection of colorectal cancer group (LRRCC, n = 90) and open surgery group (OP, n = 77). Before treatment and on the 1st, 3rd, 5th, 7th and 15th day after treatment, their serum levels of pain factors, neuropeptide Y, prostaglandin E2 and nerve growth factor were measured by a serum biochemistry analyzer, their levels of inflammatory factors including C-reactive protein, interleukin 6 (IL-6), IL-8 and tumor necrosis factor-α by ELISA, and their amount of CD3+, CD4+ and CD8+ T cell subsets were measure by flow cytometry. Anorectal motility was assessed before and 4 and 8 weeks after treatment. Survival rates were assessed using the Kaplan-Meier method.
On the 1st, 3rd, 5th, 7th and 15th day after treatment, compared with the OP group, the LRRCC group had lower levels of serum pain factors, inflammatory factors and CD8+T lymphocytes, while their numbers of CD3+ and CD4+ T lymphocytes subsets were significantly increased. Further, the LRRCC group had fewer complications and significantly higher survival rates, demonstrating better efficacy than the OP group.
Laparoscopic radical resection was effective and achieved superior outcomes than open surgery in treating colorectal cancer patients with bowel obstruction.