结肠癌完整结肠系膜切除术后乳糜漏的影响因素分析

目的探讨结肠癌完整结肠系膜切除（CME）术后乳糜漏的发生率、影响因素及防治措施。方法收集2000年9月至2011年9月间福建医科大学附属协和医院结直肠外科同一组医师连续实施的592例结肠癌CME患者的临床资料。结果592例结肠癌CME术后共发生乳糜漏46例（7．7％）,CME右半结肠切除术后乳糜漏发生率为13．3％（30／226）．显著高于CME左半结肠切除术后的4．4％（16／366）（P=0．000）。单因素回归分析结果显示,肿瘤大小（P〈0．05）、肿瘤部位（P〈0．叭）及清扫淋巴结数目（P〈0．01）与CME术后乳糜漏有关：多因素回归分析结果显示,肿瘤部位和清扫淋巴结数目是CME术后发生乳糜漏的独立危险因素（P〈0．05）。结论肿瘤部位和清扫淋巴结数目是结肠癌CME术后乳糜漏的独立危险因素。当患者术后开始进食后腹腔引流量由少而突然增加时．应积极进行乳糜试验检查．以便早期明确诊断并及时治疗。     

完整结肠系膜切除术后四例乳糜漏临床分析

目的 总结完整结肠系膜切除术所致4例乳糜漏诊治经验.方法 回顾性分析2009年11月至2011年12月收治的61例因结肠癌行完整结肠系膜切除术中4例术后并发乳糜漏患者的临床资料.结果 61例患者中有4 例术后发生乳糜漏,发生率为6.6%,右半结肠发生率100%,肿瘤分期Ⅱ期3例,Ⅲ期1例.发生乳糜漏的时间平均为术后第5(4～6)天,每日最大引流量285～490 ml,平均380 ml.全部患者经保守治疗痊愈.结论 完整结肠系膜切除术后乳糜漏多发生在右半结肠,以Ⅱ期、Ⅲ期结肠癌为主.避免发生术后乳糜漏应以术中预防为主;治疗首选支持及保守治疗.     

结直肠肿瘤的腹腔镜微创治疗临床分析

目的：探讨腹腔镜下微创治疗结直肠肿瘤的临床价值。 方法：回顾分析腹腔镜下完成结直肠肿瘤手术255例临床资料,其中腹腔镜右半结肠切除术27例,腹腔镜结肠部分切除术5例,腹腔镜左半结肠切除术13例,腹腔镜乙状结肠根治切除术40例,腹腔镜直肠癌前切除术（Dixon术）119例,腹腔镜Miles术50例,腹腔镜下全结肠切除1例。 结果：255例手术均成功切除肿瘤（255例中1例为手助式,2例为腹腔镜辅助式）,无手术死亡病例;术中发生输尿管损伤尿外溢1例,经放置输尿管支架后治愈;无其余明显术中并发症;术中出血量平均约35 mL,平均手术时间155 min（其中后80例平均手术时间130 min）。术后肠功能恢复时间平均为2.3 d;术后疑有吻合口小渗漏1例,经局部引流等治疗而愈;发生切口感染 2例,肿瘤局部浸润较深者术后尿潴留症状1例。术后随访最长75个月,随访率84.3%（215/255）, 2例复发转移,尚未发现死亡者。 结论：腹腔镜下结直肠肿瘤根治术,手术创伤小,术中操作精准,术后恢复快,手术并发症少,在一定程度上超过传统开腹结直肠肿瘤根治术的临床疗效,值得临床进一步推广。     

经脐单子L腹腔镜结直肠手术的临床应用

目的探讨经脐单孔腹腔镜结直肠手术的临床应用价值。方法回顾性分析2010年1月至2012年12月自贡市第四人民医院收治的25例结肠、直肠上段良恶性肿瘤行手术切除患者的临床资料。根据病变的部位和性质确定手术方案。采用门诊和电话随访,随访时间截至2013年3月。结果25例患者中行结直肠部分切除术14例,根治性右半结肠切除术1例,横结肠癌根治术1例,根治性左半结肠切除术1例,乙状结肠癌根治术2例,直肠癌根治术6例。22例患者成功施行经脐单孔腹腔镜结直肠手术,2例改为“四孔法”手术,1例中转开腹手术。单孔腹腔镜手术中位切口长度为3．8cm（3．5～4．5cm）,手术时间为（192±32）min,术中出血量为（61±21）mL,肿瘤中位长径为2．7cm（1．0～5．0cm）,中位淋巴结清扫数目为7枚（3～22枚）,术后平均肛门排气时间为2d（1—5d）,术后平均住院时间为8d（6～20d）。患者术后并发症发生率为8．0％（2／25）,包括切口感染1例,吻合口漏1例。11例行根治手术的患者肿瘤环周切缘均为阴性。22例行经脐单孔腹腔镜结直肠手术的患者均接受随访,中位随访时间为12个月。1例结肠癌患者术后10个月发现肝转移,其余患者均无瘤生存。结论经脐单孔腹腔镜结直肠手术安全可行,创伤小、恢复快、并发症少、切口美观。     

腹腔镜在结直肠癌根治术中的应用

目的 探讨腹腔镜结直肠癌根治术的临床应用价值.方法 回顾分析31例腹腔镜下结直肠癌根治术的临床病例资料.结果 除1例中转开腹外,其余30例均在腹腔镜下完成手术;其中右半结肠切除术8例、左半结肠切除术4例、乙状结肠切除术5例、直肠癌行直肠前切除术8例、Miles术6例.手术时间150～300 min(平均200 min)...     

腹腔镜辅助下结直肠癌切除手术的临床应用

目的 探讨腹腔镜辅助下结直肠癌切除手术的可行性和应用价值.方法 回顾性分析51例腹腔镜结直肠癌切除手术的临床资料.腹腔镜下完成结直肠手术48例,中转开腹3例.其中右半结肠切除术9例,左半结肠切除术8例,乙状结肠切除术14例,直肠前切除术11例,腹会阴联合根治术6例.结果 全组无手术死亡.腹腔镜手术时间150～320（平均195）min,术中出血40～300（平均120）Ml,手术清除淋巴结2～26（平均8）枚.术后20～72h均恢复胃肠功能,术后疼痛轻,无术中大出血、术后无特殊并发症发生.术后住院时间（不包括化疗）7～10（平均8）d.随访45例（88.2%）,随访时间3～54个月,2例死亡,均为Dukes C期直肠癌患者,1例术后17个月死于肝转移,另1例术后19个月死于腹腔广泛转移并衰竭.未发现套管穿刺部位及辅助小切口处肿瘤种植和局部复发.结论 腹腔镜结直肠癌手术在应用技术上可行,且具有创伤小、痛苦少、恢复快等特点,是治疗结直肠癌的一种微创、安全而有效的术式.     

腹腔镜下结直肠癌根治术的临床应用研究

目的:探讨腹腔镜结直肠癌根治术的临床应用价值。方法:回顾分析77例腹腔镜下结直肠癌根治术的临床病例资料,其中右半结肠切除术12例、横结肠切除术2例、左半结肠切除术12例、乙状结肠切除术8例、直肠癌行直肠前切除术19例、直肠癌行结肠拖出式切除术8例、Miles术12例、结肠次全切除术2例、全结肠切除术2例。结果:75例均在腹腔镜下完成,腹腔镜手术切除率97.4%(75/77),2例中转开腹行Miles术;手术时间平均175min;术中出血量平均110ml;术后肠蠕动恢复时间平均1.9d;术后无出血、吻合口漏、伤口感染等并发症,4例出现轻度尿潴留症状,6例术后轻度性功能障碍;术后平均住院7.5d;术后随访2~42m;死亡2人。结论:运用腹腔镜技术进行结直肠癌根治术,具有操作安全、创伤小、恢复快等特点,不仅技术上可行,而且完全可达到开腹根治术的效果。     

腹腔镜结直肠癌手术的临床分析（附45例报告）

目的：总结行腹腔镜结直肠癌根治术的临床经验。方法：回顾分析2003年5月至2007年5月45例行腹腔镜结直肠癌根治术患者的临床资料。其中右半结肠癌8例，左半结肠癌5例，乙状结肠癌20例，直肠癌12例。按传统根治术的要求术中使用超声刀或同时用结扎束游离结肠或直肠及其相应的肠系膜和淋巴、脂肪等组织。结肠癌根治术：在腹部左侧或右侧做5cm的辅助切口，腹腔外行肠切除和肠吻合。低位直肠癌行Miles手术者在充分游离乙状结肠和直肠后，在左下腹做辅助性小切口（乙状结肠造口处），切断乙状结肠后，腹部手术组行乙状结肠造口，会阴手术组经会阴行直肠切除术。结果：手助腹腔镜右半结肠癌根治术6例，左半结肠癌根治术3例，乙状结肠癌、直肠中上段癌根治术20例，腹会阴联合直肠切除术6例。腹腔镜手术35例，中转开腹10例，中转率22．2％。无死亡病例。手术时间120～280min，平均180min；出血50～100ml，平均80ml。术后随访6～36个月，平均18个月。8例肿瘤复发、转移死亡，复发率22．9％。未发现腹壁小切口和穿刺孔转移。结论：依据结直肠肿瘤分期和部位选择合适的病例，用腹腔镜完成微创手术安全可行，可以达到根治目的。     

腹腔镜辅助结直肠癌切除术14例报告

目的:探讨腹腔镜技术在结直肠癌切除术中的应用。方法:回顾分析腹腔镜辅助结直肠癌切除术14例的临床资料。结果:本组右半结肠、横结肠、左半结肠以及乙状结肠根治性切除各1例,D ixon术5例,M iles术3例;1例左半结肠癌患者探查见左肾有浸润性转移而中转开腹;1例横结肠癌患者探查见肿瘤腹腔广泛转移而放弃手术;全组无手术死亡。术后1例Dukes D期患者因肿瘤转移死亡,1例Dukes C期患者1年后肠道复发,其余患者未见肿瘤复发及转移。结论:腹腔镜辅助结直肠癌根治术安全可行。     

腹腔内与腹腔外吻合对腹腔镜右半结肠切除术后近期并发症影响分析

目的 对比分析腹腔镜右半结肠切除术中行腹腔内与腹腔外吻合后近期并发症发生情况。方法 回顾性分析2017-01-01至2021-01-07北京协和医院基本外科结直肠专业组收治的294例行腹腔镜右半结肠切除术病人的临床资料,术中行腹腔内吻合86例（腹腔内吻合组）,行腹腔外吻合208例（腹腔外吻合组）。使用Cochran-Mantel-Haenszel 检验排除分层因素的混杂作用后,分析吻合位置对腹腔感染、吻合口漏、手术切口感染等术后并发症的影响。结果 腹腔内吻合组和腹腔外吻合组在淋巴结清扫范围和吻合方式方面差异有统计学意义（P<0.05）,腹腔内吻合组行完整结肠系膜切除（CME）病人比例更高（59.5% vs. 41.8%,P=0.007）,且全部行侧侧吻合。两组获取淋巴结数目、术中出血量、手术时间方面差异均无统计学意义（P>0.05）。总体并发症发生率为28.9%（85/294）,共115例次。将所有行侧侧吻合的病人（155例）纳入并发症分析,并经分层分析排除淋巴结清扫范围和吻合方式的可能混杂作用后,腹腔内吻合组手术切口感染的发生率高于腹腔外吻合组,差异有统计学意义［18例（20.9%） vs. 3例（4.3%）,P=0.012］,而在腹腔感染（含或不含吻合口漏）、吻合口漏、呼吸系统感染、术后肠梗阻、乳糜漏方面差异则无统计学意义（P>0.05）。结论 腹腔镜右半结肠切除术病人中行腹腔内吻合者可能更易发生手术切口感染,应谨慎选择行腹腔内吻合病例。     

Risk Factors for Wound Infection After Surgery for Colorectal Cancer

BACKGROUND: Among complications after surgery for colorectal cancer, wound infections may prolong hospitalization and increase healthcare costs. This study was designed to clarify the incidence, risk factors, and pathogens responsible for wound infections after surgery for colorectal cancer. METHODS: The study group comprised 144 patients (94 men and 50 women) with colorectal cancer in whom the same surgeon at Kitasato University Hospital performed resection from January 2004 through December 2005. Their mean age was 67.1 years (range = 38-90). To identify risk factors for surgical wound infections, we examined the following 11 variables: gender, age (>65 vs. 25 vs. 180 vs. 120 vs. 相似文献   

腹腔镜治疗老年结直肠癌术后肠梗阻对血清肌酸激酶和D-二聚体的影响

目的对比分析腹腔镜与开腹手术治疗老年结直肠癌术后早期肠梗阻的发生情况以及血清肌酸激酶（CK）和D-二聚体（D-dimer）的变化意义。 方法回顾性分析广安市人民医院2014年1月至2017年1月诊治的130例老年结直肠癌患者临床资料,分析患者经腹腔镜治疗（腹腔镜组,60例）和常规开腹手术治疗（开腹组,70例）后肛门排气时间、住院天数和肠梗阻的发生率,并采用肌酸显色法检测不同手术患者治疗前后血清CK水平变化,酶联免疫吸附测定法检测两组治疗前后D-dimer的水平变化。 结果（1）与开腹组相比,腹腔镜组患者左半结肠癌根治术、右半结肠癌根治术和直肠癌根治术的手术时间及术中出血量明显降低,术后肛门排气时间及住院天数均明显缩短,肠梗阻总发生率明显降低（均P<0.05）。（2）腹腔镜组术后发生肠梗阻4例（6.7%）,开腹组术后发生肠梗阻13例（18.6%）,腹腔镜组患者肠梗阻总发生率以及左半结肠癌根治术后肠梗阻发生率较开腹组明显降低,差异有统计学意义（χ²=4.028、4.409,P=0.045、0.036）。（3）治疗后两组患者血清CK和D-dimer水平均明显降低,且腹腔镜组治疗后CK和D-dimer水平均显著低于开腹组,差异有统计学意义（P<0.01）。（4）肠梗阻患者CK和D-dimer水平显著高于未发生肠梗阻患者的水平,差异有统计学意义（t=9.235、13.877,均P<0.01）。（5）肠梗阻患者CK和D-dimer水平变化呈明显正相关性（r=0.852,P=0.012）。 结论老年腹腔镜结直肠术后肠梗阻发生率低,患者术后恢复更快,检测血清CK和D-dimer水平降低程度可以为临床更合理的治疗提供参考。     

腹腔镜与开腹结直肠癌根治术围手术期并发症发生率比较

目的 研究腹腔镜与开腹结直肠癌根治术围手术期并发症发生率的差异。方法 前瞻性、非随机对照2000年9月至2005年12月由同一组医师连续实施的214例腹腔镜结直肠癌根治术（腹腔镜手术组）与277例开腹结直肠癌根治术（开腹组）患者术中与术后2周内并发症发生率的差异。结果腹腔镜手术组中转开腹14例（6．5％）。术中腹腔镜手术组与开腹手术组并发症发生率分别为4．8％与3．6％（X^2=0．446，P〉0．05）。腹腔镜手术组出现骶前大出血、肠系膜下动脉根部出血、系膜出血、腹膜后气肿、吻合口破裂、直肠镜检并肠穿孔、阴道损伤及膈肌损伤各1例，直肠残端裂开2例；有7例予以中转开腹处理，术后无并发症出现。开腹手术组出现骶前大出血5例，直肠残端裂开与吻合口破裂各2例，输尿管损伤1例。术后腹腔镜手术组与开腹手术组并发症发生率分别为23．5％与36．8％（X^2=9．598，P〈0．01），其中并发肠梗阻分别为3．5％与6．5％（X^2=2．102，P〉0．05）；吻合口瘘分别为2．0％与3．0％（X^2=0．089，P〉0．05）；吻合口出血分别为5．8％与3．5％（X^2=1．064，P〉0．05）；乳糜瘘分别为1．5％与2．5％（X^2=0．201，P〉0．05）；肺部感染分别为7．0％与9．0％（X^2=0．635，P〉0．05）；切口感染分别为5．5％与14．1％（X^2=4．978，P〈0．05）。结论 腹腔镜结直肠癌根治术中并发症发生率与开腹手术无异，但术后并发症总发生率显著低于开腹手术。     

悬吊式免气腹腹腔镜结直肠癌根治术的临床应用

目的探讨悬吊式免气腹腹腔镜结直肠癌根治手术的可行性。方法 2008年5月～2009年10月,行悬吊式免气腹腹腔镜结直肠癌根治手术43例,其中右半结肠癌根治术10例,横结肠癌根治术3例,左半结肠癌根治术9例,直肠癌Dixon手术16例,直肠癌Miles手术5例。术后37例行FOLFOX辅助化疗方案。结果 43例手术均成功完成,无中转开腹,无死亡病例。手术时间:右半结肠切除术180～300min(平均240min),左半结肠切除术120～240min(平均180min),Dixon手术120～210min(平均150min),Miles手术170～210min(平均190min)。术中出血150ml。手术切除淋巴结10～28个,平均16个,其中阳性5个。术后恢复顺利。43例随访4～10个月,平均7个月,未见切口种植及吻合口复发,腹部CT检查未发现远处转移。结论悬吊式免气腹腹腔镜结直肠癌根治手术避免了气腹对人体血流动力学的影响,是一种安全、可行、经济的手术方法 。     

Utilization of laparoscopy in colorectal surgery for cancer at academic medical centers: does site of surgery affect rate of laparoscopy?

Use of laparoscopy in colorectal cancer surgery is still limited. The aim of this study was to determine the rate of use of laparoscopic colorectal surgery for cancer at academic medical centers and to evaluate if the site of surgery influences the rate of use. Clinical data of patients who underwent laparoscopic or open colon and rectal resections for cancer from 2007 to 2009 were obtained from the University HealthSystem Consortium database. Data concerning rate of laparoscopy, length of stay, morbidity, and risk-adjusted mortality were obtained. During the 36-month study period, 22,780 operations were performed. The overall rate for use of laparoscopy was 14.8 per cent. Laparoscopy was most often used for total colectomy (22.6%), sigmoid colectomy (17.3%), cecectomy (17.1%), and right hemicolectomy (17.0%). Laparoscopy was most infrequently used for abdominoperineal resection (8.0%), transverse colectomy (10.0%), and left hemicolectomy (13.1%). Length of stay for laparoscopic colon and rectal procedures was 3.2 days shorter than for open surgery. Although the benefits of laparoscopic colorectal surgery for cancer have been demonstrated, the use of laparoscopy for colorectal resection remains under 20 per cent for colon cancer and under 10 per cent for rectal cancer. Further studies are needed to determine the factors limiting the use of laparoscopy in colorectal surgery.     

Colorectal cancer in aged patients. Toward the routine treatment through laparoscopic surgical approach

Aim

Colorectal cancer is one of the most common malignancies in general population. The incidence seems to be higher in older age. Surgery remains the treatment of choice and laparoscopic approach offers numerous benefits. We report our personal experience in elderly patients operated on for colorectal cancer with laparoscopic resection.

Patients and methods

From January 2003 to September 2013, out of 160 patients aged 65 years or older and operated with minimally invasive techniques, 30 cases affected by colorectal cancer and operated on with laparoscopic approach were analyzed in this study.

Results

Male/female ratio was 1.35 and mean age 72 years. Constipation, weight loss, anemia and rectal bleeding were the most commonly reported symptoms. Lesions involved descending-sigmoid colon in 53% of cases, rectum in 37% and ascending colon in 10%. Among laparoscopic colorectal operations laparoscopic left colectomy was the most frequently performed, followed by right colectomy, abdominoperineal resection and Hartmann procedure. Operative times ranged from 3 to 5 hours depending on surgical procedure performed. Mean hospital stay was 6 days (range 4–9). Conversion to open approach occurred only in a case of laparoscopic right colectomy (3%) for uncontrolled bleeding. A single case of mortality was reported. In two cases (7%) anastomotic leakage was observed, conservatively treated in one patient and requiring reoperation in the other one.

Conclusions

Laparoscopic colorectal surgery is feasible and effective for malignancies in elderly population offering several advantages including immunologic and oncologic ones. However an experienced surgical team is essential in reducing risks and complications.     

Laparoscopic surgery for stage III colon cancerrid=""

BACKGROUND: The role of laparoscopic surgery in the management of colorectal cancer is controversial. This study was undertaken to determine the oncological adequacy, in terms of margins of resection, lymph node harvest, and anastomotic and locoregional recurrence of laparoscopic colectomy in patients with stage III (node-positive) colorectal cancer. METHODS: The results of laparoscopic colectomy in 50 consecutive patients with stage III colorectal cancer operated on at a single hospital between 1991 and 1998 were analyzed with respect to postoperative morbidity, mortality, and long-term survival by the Kaplan-Meier method. Methodical patient follow-up was the mainstay of the study. RESULTS: There were 31 men (52%) and 19 women (38%) with a mean age of 67.7 years (range, 40-88). Low anterior resection was performed in 17 cases, abdominal perineal resection in five cases sigmoid colectomy in 10 cases, left hemicolectomy in six cases, right hemicolectomy in seven cases, transverse colectomy in one case, and subtotal colectomy in four cases. Conversion was necessary in three cases (6%). Major complications included one leak, one pelvic abscess, one perineal wound infection, and three anastomotic strictures early in the experience, with none in the past 4 years. One early death occurred due to massive stroke. Median length of stay was 6 days (range, 3-37). Forty-six patients were staged as CII and four as CI colon cancer. The average number of positive nodes was 5.1 (range, 3-58). The margins of resection were adequate in all patients. Follow-up ranged from 3 to 75 months (average, 29.3; median, 24). Overall cancer-related mortality was 34% (17 patients); three patients died of unrelated causes with no detectable cancer. All who died of cancer had distant disease; three of them also had pelvic recurrence. Mean time of death was 21.7 months. There were no anastomotic recurrences or trocar site implants. Overall 3- and 5-year survival was 54.5% and 38.5%, respectively; cancer-adjusted survival was 60.8% and 49.1%. CONCLUSIONS: Based on this study, laparoscopic colectomy in patients with stage III colorectal cancer is oncologically adequate. It results in a long-term outcome comparable to that of traditional open surgery and is associated with low perioperative mortality and morbidity (lower wound infection rate, lower wound recurrences at trocar sites) and a shortened length of stay.     

腹腔镜与开腹结直肠癌根治术后全身炎症反应综合征比较

目的 观察腹腔镜和开腹结直肠癌根治术患者术后全身炎症反应综合征(SIRS)的发生,比较两种不同手术方式对患者的创伤程度.方法 将85例结直肠癌患者分成开腹手术组(OP组,n=33)和腹腔镜手术组(LP组,n=52),检测术后患者SIRS发生率和持续时间,采用酶联免疫吸附法(ELISA)连续检测血清肿瘤坏死因子(TNF)-а、白细胞介素(IL)-6及IL-10水平.结果 与OP组比较,LP组患者血清TNF-а和IL-6水平明显降低,IL-10水平升高,差异有统计学意义(P<0.01).LP组SIRS发生率为36.5%,低于OP组的63.6%(P<0.01),SIRS持续时间短于OP组(P<0.05).结论 腹腔镜结直肠癌根治术术后患者SIRS发生率和程度较低,对机体创伤较小.     

梗阻性结直肠癌导管减压后3D腹腔镜与开腹手术的疗效比较

目的:比较梗阻性结直肠癌导管减压后行3D腹腔镜与开腹根治术的疗效。方法:回顾性分析2011年5月—2013年6月96例行手术治疗的梗阻性结直肠癌患者资料,所有患者术前均行肠梗阻导管置入减压,然后50例行3D腹腔镜下行结直肠癌根治术3D(腹腔镜手术组),46例行传统开腹结直肠癌根治手术(开腹手术组),比较两组患者的相关临床指标。结果:两组患者术前资料具有可比性;腹腔镜手术组平均手术时间长于开腹手术组(5.9 h vs.5.2 h,P0.05),平均总住院费用高于开腹手术组(3.3万元vs.2.7万元,P0.05),但平均术后排气时间(2.4 d vs.3.0 d,P0.05)、留置尿管时间(2.7 d vs.3.9 d,P0.05)、住院时间(15.2 d vs.23.8 d,P0.05)均明显短于开腹手术组;两组患者术后吻合口瘘、切口感染、腹腔脓肿和肠梗阻发生率差异均无统计学差异(均P0.05);两组患者3年无瘤生存率无统计学差异(80.0%vs.82.6%,P=0.744)。结论:3D腹腔镜手术治疗导管减压后梗阻性结直肠癌术后恢复快,且围手术期并发症与预后方面与开腹手术相似,可作为梗阻性结直肠癌治疗的手术方式。     

腹腔镜与开腹结直肠癌根治术后患者疼痛反应及细胞免疫水平的差异分析

目的分析腹腔镜辅助结直肠癌根治术与常规开腹术后患者疼痛反应及细胞免疫水平的差异。 方法回顾性分析2014年6月至2016年12月60例结直肠癌患者,根据治疗方法分为腹腔镜组(32例)和开腹组(28例)。腹腔镜组行腹腔镜辅助结肠癌根治术,开腹组行常规开腹术。采用SPSS20.0软件进行统计学分析,术中术后各项指标和T细胞亚群水平等以( ±s)表示,采用独立t检验;术后并发症发生率等组间比较采用χ²检验,P<0.05为差异具有统计学意义。 结果腹腔镜组的术后出血量、术后引流时间、进食时间、住院时间均低于开腹组,差异具有统计学意义(P<0.05);腹腔镜组术后VAS评分及镇痛药使用次数均低于开腹组(P<0.05);术后,腹腔镜组的CD3^＋、CD4^＋水平高于开腹组(P<0.05);术后并发症发生率腹腔镜组为6.25%(2/32)低于开腹组32.14%(9/28),差异有统计学意义(P<0.05)。 结论在结直肠癌手术治疗上,腹腔镜辅助结直肠癌根治术对患者术中创伤小及并发症发生风险低,且有效缓解患者的疼痛症状和免疫应激反应,有利于患者的术后恢复,值得临床上应用及推广。