减孔腹腔镜手术治疗结直肠癌对胃肠功能恢复时长及生存质量的影响
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摘要
目的探讨减孔腹腔镜手术治疗结直肠癌的临床疗效。方法回顾性分析2015年1月至2017年12月120例接受腹腔镜手术治疗的结直肠癌患者资料,分为减孔组和传统组,各60例。采用SPSS23.0统计学软件,两组间疗效评定、并发症发生率采用卡方检验;术中术后指标、血清胃泌素、胃动素水平及SF-36评分以(■±s)表示,采用独立t检验,P<0.05差异有统计学意义。结果减孔组有效率、血清胃泌素、胃动素水平及SF-36生活质量评分均高于传统组(P<0.05),而并发症发生率,术后肠鸣音恢复时间,排气、排便和进食时间均少于传统组(P<0.05)。结论减孔腹腔镜手术治疗结直肠癌可有效缩短胃肠功能恢复时长,改善患者生存质量。
Objective To investigate the effect of reduced port laparoscopic surgery on the recovery of gastrointestinal function and the quality of life in patients with colorectal cancer. Methods 120 cases of colorectal cancer were collected from January 2015 to December 2017 in our hospital. They were randomly divided into reduced port laparoscope treatment group(reduced port group) and the traditional laparoscopy group(traditional group), each 60 cases. The curative effect, the recovery time of gastrointestinal function and the quality of life between the two groups were observed. In this study, SPSS23.0 statistical software was used. The efficacy and complication rates of the two groups were compared by chi square. Intraoperative and postoperative data, serum gastrin, motilin levels and SF-36 scores of two groups were compared by independent t test, P<0.05 difference was statistically significant. Results The effective rate of the reduced port group was higher than the traditional group, the incidence of complications was lower than the traditional group. Bowel sounds recovery time, exhaust time, defecation time and feeding time were all lower than those of the traditional group. The serum levels of gastrin and motilin were higher than those of the traditional group, and the life quality of SF-36 was higher than that of the traditional group, P <0.05.Conclusion Reduced port laparoscopic surgery for patients with colorectal cancer can effectively shorten the recovery time of gastrointestinal function and improve the life quality.
Objective To investigate the effect of reduced port laparoscopic surgery on the recovery of gastrointestinal function and the quality of life in patients with colorectal cancer. Methods 120 cases of colorectal cancer were collected from January 2015 to December 2017 in our hospital. They were randomly divided into reduced port laparoscope treatment group(reduced port group) and the traditional laparoscopy group(traditional group), each 60 cases. The curative effect, the recovery time of gastrointestinal function and the quality of life between the two groups were observed. In this study, SPSS23.0 statistical software was used. The efficacy and complication rates of the two groups were compared by chi square. Intraoperative and postoperative data, serum gastrin, motilin levels and SF-36 scores of two groups were compared by independent t test, P<0.05 difference was statistically significant. Results The effective rate of the reduced port group was higher than the traditional group, the incidence of complications was lower than the traditional group. Bowel sounds recovery time, exhaust time, defecation time and feeding time were all lower than those of the traditional group. The serum levels of gastrin and motilin were higher than those of the traditional group, and the life quality of SF-36 was higher than that of the traditional group, P <0.05.Conclusion Reduced port laparoscopic surgery for patients with colorectal cancer can effectively shorten the recovery time of gastrointestinal function and improve the life quality.
引文
[1] 迟岳峰.腹腔镜结直肠癌根治与传统根治手术疗效的临床效果对比分析[J/CD].中华普外科手术学杂志:电子版,2016,10(2):130-132.
[2] Byrne BE,Vincent CA,Faiz OD.Inequalities in Implementation and Different Outcomes During the Growth of Laparoscopic Colorectal Cancer Surgery in England:A National Population-Based Study from 2002 to 2012[J].World J Surg,2018,42(10):3422-3431.
[3] Morelli L,Cobuccio L,Lorenzoni V,et al.Five-Years Experience of Robotic Vs Laparoscopic Colorectal Cancer Surgery in a Single Center:Surgical Parameters and Costs[J].Value Health,2015,18(7):A445-A445.
[4] Fujii S,Tsukamoto M,Shimada R,et al.Absorptive anti-adhesion barrier for the prevention of bowel obstruction after laparoscopic colorectal cancer surgery[J].J Anus Rectum Colon,2018,2(1):1-8.
[5] 李秀玲,马新英,赵阳,等.团体心理治疗对康复期结直肠癌患者情绪和生活质量的影响[J].中国健康心理学杂志,2018,26(3):366-369.
[6] Hussain A,Mahmood F,Torrance AW,et al.Impact of medial-to-lateral vs lateral-to-medial approach on short-term and cancer-related outcomes in laparoscopic colorectal surgery:A retrospective cohort study[J].Ann Med Surg(Lond),2017,26:19-23.
[7] 刘刚,沈晓军,孙克康,等.腹腔镜结直肠癌切除术后快速康复理念对患者胃肠功能恢复及并发症的影响[J].中国临床研究,2018,31(1):66-69.
[8] 宋海良,李亚军,王晓琴,等.减孔较五孔腹腔镜对结直肠癌根治性切除术中出血量、淋巴结清扫数目及恢复情况分析[J/CD].中华普外科手术学杂志(电子版),2017,11(5):403-405.
[9] Park HE,Kim MK,Kang WK.Efficacy and Safety of Ramosetron Injection for Nausea and Vomiting in Colorectal-Cancer Patients Undergoing a Laparoscopic Colectomy:A Randomized,Double-Blind,Comparative Study[J].Ann Coloproctol,2018,34(1):36-41.
[10] 宋海良,李亚军,王晓琴,等.经脐减孔与常规腹腔镜结直肠癌根治性切除术的临床研究[J].岭南现代临床外科,2017,17(5):523-527.
[11] 廖健南,区小卫,欧阳少勇,等.常规器械经脐减孔腹腔镜结直肠癌根治术的临床应用[J].中国微创外科杂志,2017,17(8):701-703.
[12] Ivanecz A,Krebs B,Stozer A,et al.Simultaneous Pure Laparoscopic Resection of Primary Colorectal Cancer and Synchronous Liver Metastases:A Single Institution Experience with Propensity Score Matching Analysis[J].Radiol Oncol,2017,52(1):42-53.
[13] 余启松,黄合超,丁峰,等.腹腔镜结直肠癌根治术对结直肠癌患者胃肠功能和生存质量的影响[J].中国临床医生杂志,2017,45(8):76-79.
[14] 高王军,李福广.腹腔镜结直肠癌根治术对结直肠癌患者临床疗效及胃肠功能的影响[J].癌症进展,2016,14(9):910-912.
[15] 阮利斌,何斌.腹腔镜结直肠癌根治术的临床疗效及对患者胃肠功能的影响[J].腹腔镜外科杂志,2016,21(8):601-603.
[16] Yang ZF,Wu DQ,Wang JJ,et al.Short- and long-term outcomes following laparoscopicvsopen surgery for pathological T4 colorectal cancer:10 years of experience in a single center[J].World J Gastroenterol,2018,24(1):76-86.
[17] 韩刚,龚航军,王以东,等.腹腔镜与开腹结直肠癌根治术对胃肠功能及远期预后的比较分析[J].腹腔镜外科杂志,2016,21(6):433-436.
[18] 赵智力,杜记涛,万相斌,等.减孔腹腔镜直肠前切除术在中高位直肠癌的应用[J].医药论坛杂志,2016,37(3):22-24.
[19] Kang JH,Lee SY,Kim CH,et al.Comparison of the short-term outcomes of reduced-port laparoscopic surgery and conventional multiport surgery in colon cancer:a propensity score matching analysis[J].Ann Surg Treat Res,2018,94(3):147-153.
[2] Byrne BE,Vincent CA,Faiz OD.Inequalities in Implementation and Different Outcomes During the Growth of Laparoscopic Colorectal Cancer Surgery in England:A National Population-Based Study from 2002 to 2012[J].World J Surg,2018,42(10):3422-3431.
[3] Morelli L,Cobuccio L,Lorenzoni V,et al.Five-Years Experience of Robotic Vs Laparoscopic Colorectal Cancer Surgery in a Single Center:Surgical Parameters and Costs[J].Value Health,2015,18(7):A445-A445.
[4] Fujii S,Tsukamoto M,Shimada R,et al.Absorptive anti-adhesion barrier for the prevention of bowel obstruction after laparoscopic colorectal cancer surgery[J].J Anus Rectum Colon,2018,2(1):1-8.
[5] 李秀玲,马新英,赵阳,等.团体心理治疗对康复期结直肠癌患者情绪和生活质量的影响[J].中国健康心理学杂志,2018,26(3):366-369.
[6] Hussain A,Mahmood F,Torrance AW,et al.Impact of medial-to-lateral vs lateral-to-medial approach on short-term and cancer-related outcomes in laparoscopic colorectal surgery:A retrospective cohort study[J].Ann Med Surg(Lond),2017,26:19-23.
[7] 刘刚,沈晓军,孙克康,等.腹腔镜结直肠癌切除术后快速康复理念对患者胃肠功能恢复及并发症的影响[J].中国临床研究,2018,31(1):66-69.
[8] 宋海良,李亚军,王晓琴,等.减孔较五孔腹腔镜对结直肠癌根治性切除术中出血量、淋巴结清扫数目及恢复情况分析[J/CD].中华普外科手术学杂志(电子版),2017,11(5):403-405.
[9] Park HE,Kim MK,Kang WK.Efficacy and Safety of Ramosetron Injection for Nausea and Vomiting in Colorectal-Cancer Patients Undergoing a Laparoscopic Colectomy:A Randomized,Double-Blind,Comparative Study[J].Ann Coloproctol,2018,34(1):36-41.
[10] 宋海良,李亚军,王晓琴,等.经脐减孔与常规腹腔镜结直肠癌根治性切除术的临床研究[J].岭南现代临床外科,2017,17(5):523-527.
[11] 廖健南,区小卫,欧阳少勇,等.常规器械经脐减孔腹腔镜结直肠癌根治术的临床应用[J].中国微创外科杂志,2017,17(8):701-703.
[12] Ivanecz A,Krebs B,Stozer A,et al.Simultaneous Pure Laparoscopic Resection of Primary Colorectal Cancer and Synchronous Liver Metastases:A Single Institution Experience with Propensity Score Matching Analysis[J].Radiol Oncol,2017,52(1):42-53.
[13] 余启松,黄合超,丁峰,等.腹腔镜结直肠癌根治术对结直肠癌患者胃肠功能和生存质量的影响[J].中国临床医生杂志,2017,45(8):76-79.
[14] 高王军,李福广.腹腔镜结直肠癌根治术对结直肠癌患者临床疗效及胃肠功能的影响[J].癌症进展,2016,14(9):910-912.
[15] 阮利斌,何斌.腹腔镜结直肠癌根治术的临床疗效及对患者胃肠功能的影响[J].腹腔镜外科杂志,2016,21(8):601-603.
[16] Yang ZF,Wu DQ,Wang JJ,et al.Short- and long-term outcomes following laparoscopicvsopen surgery for pathological T4 colorectal cancer:10 years of experience in a single center[J].World J Gastroenterol,2018,24(1):76-86.
[17] 韩刚,龚航军,王以东,等.腹腔镜与开腹结直肠癌根治术对胃肠功能及远期预后的比较分析[J].腹腔镜外科杂志,2016,21(6):433-436.
[18] 赵智力,杜记涛,万相斌,等.减孔腹腔镜直肠前切除术在中高位直肠癌的应用[J].医药论坛杂志,2016,37(3):22-24.
[19] Kang JH,Lee SY,Kim CH,et al.Comparison of the short-term outcomes of reduced-port laparoscopic surgery and conventional multiport surgery in colon cancer:a propensity score matching analysis[J].Ann Surg Treat Res,2018,94(3):147-153.