腹腔镜辅助下大肠外翻拖出式手术对结肠癌VEGF-A、VEGF-C及VEGF-D表达的影响

目的探讨腹腔镜辅助下大肠外翻拖出式手术治疗结肠癌的临床效果及对表皮生长因子(VEGF)-(A、C、D)表达的影响。方法选择64例结肠癌患者作为对象,随机数字表分为对照组(n=32)和观察组(n=32)。对照组给予腹腔镜辅助下直肠前切除术治疗,观察组采用腹腔镜辅助下大肠外翻拖出式手术治疗,术后5 d对患者效果进行评估。2组手术前、手术后均采用酶联免疫吸附试验(ELISA)测定患者VEGF-A、VEGF-C及VEGF-D表达水平,比较2组手术参数、VEGF-A、VEGF-C及VEGF-D表达水平及术后并发症及复发率。结果 2组手术时间比较,差异无统计学意义(P> 0. 05);观察组日均排便次数,多于对照组(P <0. 05);观察组术后肠道恢复、住院时间、术中出血量,均短(少)于对照组(P <0. 05)。观察组手术后5 d VEGF-A、VEGF-C及VEGF-D水平,均低于对照组(P <0. 05)。观察组手术后吻合口瘘、切口感染、皮下气肿、腹腔出血发生率及术后6个月复发率,均低于对照组(P <0. 05)。结论将腹腔镜辅助下大肠外翻拖出式手术治疗结肠癌手术创伤较小,并能降低VEGF-A、VEGF-C及VEGF-D表达水平,且术后并发症、复发率较低,值得推广应用。

Effect of Laparoscopic Assisted Large Bowel Valgus Surgery on the Expression of VEGF-A,VEGF-C and VEGF-D in Colon Cancer

Objective To investigate the clinical effect of laparoscopic assisted maxillary valgus surgery on colon cancer and its effect on the expression of epidermal growth factor( VEGF)-( A,C,D). Methods 64 patients with colon cancer were enrolled. The random number table was divided into the control group( n = 32) and the observation group( n = 32). The control group was treated with laparoscopic assisted anterior rectal resection. The observation group was treated with laparoscopic assisted maxillary valgus surgery. The patient’s effect was evaluated 5 days after operation. The expression levels of VEGF-A,VEGF-C and VEGF-D were measured by enzyme-linked immunosorbent assay( ELISA) before and after surgery. The surgical parameters,VEGF-A,VEGF-C and VEGF-D expression level and postoperative complications and recurrence rates were compared between the 2 groups. Results There was no significant difference in the operation time between the 2 groups( P > 0. 05). The daily average number of bowel movements in the observation group was higher than that of the control group( P < 0. 05). The postoperative intestinal recovery,hospitalization time,intraoperative bleeding in the observation group were all shorter( less) than the control group( P < 0. 05). The levels of VEGF-A,VEGF-C and VEGF-D were significantly lower in the observation group than the control group( P < 0. 05). The incidence of oral fistula,wound infection,subcutaneous emphysema,abdominal hemorrhage and recurrence rate at 6 months after operation were lower than those of the control group( P < 0. 05). Conclusion Laparoscopically assisted maxillary valgus surgery for colon cancer has less trauma and can reduce the expression of VEGF-A,VEGF-C and VEGFD,and the postoperative complications and recurrence rate are low. It is worth promoting.