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减少切口腹腔镜手术对结直肠癌患者围手术期指标、术后恢复及血清炎症的影响。

Influence of reduced-port laparoscopic surgery on perioperative indicators, postoperative recovery, and serum inflammation in patients with colorectal carcinoma.

作者信息

Wu Hong-Biao, Liu Dong-Fang, Liu Ye-Lei, Wang Xiao-Feng, Cao Yue-Peng

机构信息

Department of Colorectal Surgery, The First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang Province, China.

出版信息

World J Gastrointest Surg. 2024 Jun 27;16(6):1734-1741. doi: 10.4240/wjgs.v16.i6.1734.

Abstract

BACKGROUND

Conventional five-port laparoscopic surgery, the current standard treatment for colorectal carcinoma (CRC), has many disadvantages.

AIM

To assess the influence of reduced-port laparoscopic surgery (RPLS) on perioperative indicators, postoperative recovery, and serum inflammation indexes in patients with CRC.

METHODS

The study included 115 patients with CRC admitted between December 2019 and May 2023, 52 of whom underwent conventional five-port laparoscopic surgery (control group) and 63 of whom underwent RPLS (research group). Comparative analyses were performed on the following dimensions: Perioperative indicators [operation time (OT), incision length, intraoperative blood loss (IBL), and rate of conversion to laparotomy], postoperative recovery (first postoperative exhaust, bowel movement and oral food intake, and bowel sound recovery time), serum inflammation indexes [high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6)], postoperative complications (anastomotic leakage, incisional infection, bleeding, ileus), and therapeutic efficacy.

RESULTS

The two groups had comparable OTs and IBL volumes. However, the research group had a smaller incision length; lower rates of conversion to laparotomy and postoperative total complication; and shorter time of first postoperative exhaust, bowel movement, oral food intake, and bowel sound recovery; all of which were significant. Furthermore, hs-CRP, IL-6, and TNF-α levels in the research group were significantly lower than the baseline and those of the control group, and the total effective rate was higher.

CONCLUSION

RPLS exhibited significant therapeutic efficacy in CRC, resulting in a shorter incision length and a lower conversion rate to laparotomy, while also promoting postoperative recovery, effectively inhibiting the inflammatory response, and reducing the risk of postoperative complications.

摘要

背景

传统五孔腹腔镜手术是目前结直肠癌(CRC)的标准治疗方法,但存在诸多缺点。

目的

评估减孔腹腔镜手术(RPLS)对CRC患者围手术期指标、术后恢复及血清炎症指标的影响。

方法

本研究纳入2019年12月至2023年5月收治的115例CRC患者,其中52例行传统五孔腹腔镜手术(对照组),63例行RPLS(研究组)。对以下维度进行比较分析:围手术期指标[手术时间(OT)、切口长度、术中出血量(IBL)及开腹转换率]、术后恢复情况(术后首次排气、排便及经口进食时间和肠鸣音恢复时间)、血清炎症指标[高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)]、术后并发症(吻合口漏、切口感染、出血、肠梗阻)及治疗效果。

结果

两组的OT和IBL量相当。然而,研究组切口长度更小;开腹转换率和术后总并发症发生率更低;术后首次排气、排便、经口进食及肠鸣音恢复时间更短,差异均有统计学意义。此外,研究组hs-CRP、IL-6及TNF-α水平显著低于基线水平及对照组,总有效率更高。

结论

RPLS在CRC治疗中显示出显著疗效,切口长度更短,开腹转换率更低,同时促进术后恢复,有效抑制炎症反应,降低术后并发症风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fdd/11230031/da3535c804bc/WJGS-16-1734-g001.jpg

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