Mari Giulio M, Crippa Jacopo, Costanzi Andrea T M, Pellegrino Roberta, Siracusa Claudia, Berardi Valter, Maggioni Dario
ASST Monza, Desio Hospital, General Surgery Unit, Via Mazzini, Desio (MB).
General Surgery.
Surg Laparosc Endosc Percutan Tech. 2018 Apr;28(2):77-81. doi: 10.1097/SLE.0000000000000506.
Total laparoscopic right hemicolectomy is a procedure that involves an intracorporeal anastomosis. This approach may reduce tissue injury resulting in a significant lower surgical stress response (SSR) compared with the same procedure performed with an extracorporeal anastomosis. The purpose of this study was to compare the SSR level between 2 groups of patients undergoing laparoscopic right hemicolectomy with intracorporeal or extracorporeal anastomosis. From June 2015 to December 2016, 60 patients were enrolled and randomized. Interleukin-6, C-reactive protein, procalcitonin, white blood cell count, cortisol, prolactin, prealbumin, albumin, triglycerides, and transferrin were analyzed preoperatively and at 1, 3, and 5 days postoperatively. Interleukin-6 and C-reactive protein levels were significantly lower in the intracorporeal group on days 1, 3, and 5 postoperatively compared with the extracorporeal group. Gastrointestinal recovery was significantly earlier in the intracorporeal group. The intracorporeal anastomosis in laparoscopic right hemicolectomy reduces SSR, which may play a role in bowel recovery.
全腹腔镜下右半结肠切除术是一种涉及体内吻合的手术。与采用体外吻合进行的相同手术相比，这种方法可能会减少组织损伤，从而显著降低手术应激反应（SSR）。本研究的目的是比较两组接受腹腔镜下右半结肠切除术并采用体内或体外吻合的患者的SSR水平。2015年6月至2016年12月，60例患者入组并随机分组。术前及术后1天、3天和5天分析白细胞介素-6、C反应蛋白、降钙素原、白细胞计数、皮质醇、催乳素、前白蛋白、白蛋白、甘油三酯和转铁蛋白。术后第1天、3天和5天，体内吻合组的白细胞介素-6和C反应蛋白水平明显低于体外吻合组。体内吻合组的胃肠道恢复明显更早。腹腔镜下右半结肠切除术的体内吻合可降低SSR，这可能对肠道恢复起作用。
