开放和腹腔镜直肠癌根治术患者术后早期全身与腹腔炎性反应的差异

目的:探讨开放和腹腔镜直肠癌根治术患者术后早期全身与腹腔炎性的反应。方法:选取我院直肠癌患者210例,开放直肠癌根治术为108例,腹腔镜根治术患者102例,开放直肠癌根治术组为对照组,腹腔镜根治术患者为实验组。对比手术一般指标以及术后炎症反应指标。结果:手术一般指标:对照组的切口长度、手术时间、排气时间、并发症发生率、住院时间和4天引流量均显著大于实验组,此6项差异存在统计学意义(P0.05);对照组的术中出血量、术后第1天引流量略高于实验组,此2项无统计学意义(P0.05)。炎症指标:术前2组4项炎症指标均无统计学意义(P0.05)。血液检查:术后第1天差异具有统计学意义(P0.05);术后第4天差异无统计学意义(P0.05);腹部引流物检查:第1天对照组的炎症指标均高于实验组,但差异无统计学意义(P0.05),术后第4天对照组的炎症指标均显著高于实验组,差异具有统计学意义(P0.05)。结论:对比于传统直肠癌开放手术,腹腔镜直肠癌根治术具有创伤小、住院时间短及恢复快等优势,同时腹腔镜手术在术后炎症消退速度更快,更有利于患者恢复。

Differences of Systemic and Intraperitoneal Inflammatory Response in Patients after Open or Laparoscopic Radical Surgery of Rectal Cancer

ABSTRACT Objective: To explore the differences of systemic and abdominal inflammatory response in patients after open or la- paroscopic radical resection of rectal cancer. Methods: 210 patients with rectal cancer in our hospital were chosen. 108 patients who un- derwent open radical resection of rectal cancer were taken as control group. 102 patients who had laparoscopic radical operation were taken as experimental group. The general indicators of surgery and postoperative inflammatory reaction index were compared between the two groups. Results: The general index of operation such as length of incision, operation time, exhaust time, incidence of complica- tions, hospitalization time and the fourth day induced flow rate were significantly higher in the control group than in the experimental group, and the difference was statistically significant (P<0.05). The amount of bleeding during operation and induced flow of the first day were slightly higher in the control group than in the experience group, and the difference had no statistical significance (P>0.05). There were no differences in the four indexes of inflammation before operation between the two groups (P>0.05). Blood examination showed that the difference of the first day was statistically significant (P<0.05), but it was not statistically significant in the fourth day after opera- tion (P>0.05). Abdominal drainage detection results showed the indexes of inflammation in the control group were higher than in the ex- perimental group in the first day but the difference was not statistically significant(P>0.05), but they were significantly higher in control group than in experimental group in the fourth day with statistically significant difference (P<0.05). Conclusion: Compared with open surgery, laparoscopic radical resection of rectal cancer has the advantages of less trauma, shorter hospital stay and rapid recovery. At the same time, the rate of inflammation subsided after laparoscopic surgery was faster and more conducive to the recovery of patients.