摘要
目的探究不同辅助性切口腹腔镜直肠根治术治疗老年直肠癌(RC)患者术后胃肠功能恢复及切口疝的影响。方法选取2018年1月—2021年1月于首都医科大学附属北京潞河医院收治的老年RC患者80例为研究对象,根据不同辅助性切口术式分为观察组(n=40)和对照组(n=40)。对照组予以左下腹斜行辅助性切口,观察组则予以脐上纵行辅助性切口。对比手术前后2组恢复情况[手术指标、肠胃功能、疼痛情况(疼痛评分)]和血液指标[血清胃动素(MTL)、胃泌素(GAS)、活性肠肽(VIP)、血清中神经肽Y(NPY)、神经生长因子(NGF)和缓激肽(BK)]水平;观察术后伴随并发症概率。结果观察组术中出血量以及术后首次排气时间、首次排便时间显著少于对照组,而清扫淋巴结节数量高于对照组(P<0.05);术后3d,观察组MLT、GAS、VIP水平显著低于对照组(P<0.05);VAS评分及NPY、NGF、BK水平均低于对照组(P<0.05);术后2组并发症总发生率差异无统计学上意义(P>0.05)。结论与腹腔镜RC根治术左下腹斜行辅助性切口术式比较,采用脐上纵行辅助性切口有助于减轻患者手术出血量及术后疼痛,并减少对胃肠功能干扰,同时不会增加术后并发症发生率,值得临床上推广应用。
Objective To explore the effects of different adjuvant incisions for laparoscopic radical rectal resection on postoperative gastrointestinal function recovery and incisional hernia in elderly patients with rectal cancer(RC).Methods80elderly RC patients admitted to Beijing Luhe Hospital Affiliated to Capital Medical University from January2018to January2021were selected as the research subjects.They were divided into observation group(n=40)and control group(n=40)according to different auxiliary incision.The control group was treated with an oblique auxiliary incision in the left lower abdomen,while the observation group was treated with the supraumbilical longitudinal auxiliary incision.The recovery condition[operation index,gastrointestinal function,pain degree(VAS score)]and blood indexes[serum motilin(MTL),gastrin(GAS),vasoactive intestinal peptide(VIP),serum neuropeptide Y(NPY),nerve growth factor(NGF)and bradykinin(BK)]were compared between the two groups before and after operation.Postoperative complications were observed.Results The amount of intraoperative bleeding,the postoperative first exhaust time and first defecation time in the observation group were significantly less than those in the control group,while the number of dissected lymph nodes in the observation group was more than that in the control group(P<0.05).On the3rd day after operation,the levels of MLT,GAS and VIP in the observation group were significantly lower than those in the control group(P<0.05),while the VAS scoreand the levels of NPY,NGF and BK were lower than those in the control group(P<0.05).The difference in total incidence of postoperative complications between the two groups was not statistically significant(P>0.05).Conclusion Compared with the oblique auxiliary incision in the left lower abdomen,the supraumbilical longitudinal auxiliary incisionfor laparoscopic radical resection of rectal cancercan reduce the intraoperative blood loss and postoperative pain,reduce the disturbance to gastrointestinal function,and will not incre
作者
李若凡
高旭
齐辉
LI Ruofan;Gao Xu;Qi Hui(Department of General Surgery,Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing,101149,P.R.China)
出处
《老年医学与保健》
CAS
2022年第3期484-487,共4页
Geriatrics & Health Care
基金
潞河医院医学发展科研基金(2020-KY-042)。
关键词
老年
腹腔镜直肠根治术
辅助性切口
切口疝
血浆胃动素
血浆胃泌素
elderly
laparoscopic radical resection of rectal cancer
auxiliary incision
incisional hernia
plasma motilin
plasma gastrin
