腹腔镜下根治术对结直肠癌患者胃肠功能、氧化应激及免疫功能的影响

目的探讨腹腔镜下根治术对结直肠癌患者胃肠功能、氧化应激及免疫功能影响。 方法前瞻性研究选择2018年1月至2020年12月邢台市人民医院收治的结直肠癌患者113例，依据随机数字表法随机分为腹腔镜组57例与开腹组56例。腹腔镜组实施腹腔镜下结直肠癌根治术治疗，开腹组实施开腹结直肠癌根治术治疗。记录2组围术期指标（包括术中出血量、手术时间和住院时间），术后胃肠功能恢复情况，术后并发症情况；术前、术后24 h和术后72 h胃肠激素（胃泌素和胃动素）、氧化应激［超氧化物歧化酶（SOD）和丙二醛（MDA）］和免疫功能［免疫球蛋白A（IgA）、免疫球蛋白G（IgG）和免疫球蛋白M（IgM）］变化。 结果腹腔镜组术中出血量少于开腹组，手术时间和住院时间短于开腹组（P＜0.05）。腹腔镜组排气时间和进食时间短于开腹组（P＜0.05）。腹腔镜组术后并发症少于开腹组（P＜0.05）。腹腔镜组术后24 h和术后72 h患者胃泌素和胃动素水平高于开腹组（P＜0.05）。腹腔镜组术后24 h和术后72 h患者SOD水平高于开腹组，而MDA水平低于开腹组（P＜0.05）。腹腔镜组术后24 h和术后72 h患者IgA、IgG和IgM水平高于开腹组（P＜0.05）。 结论腹腔镜下根治术可促进结直肠癌患者胃肠功能恢复，术后并发症少，及对患者氧化应激和免疫功能影响小。

Effect of laparoscopic radical resection on gastrointestinal function,oxidative stress,and immune function in patients with colorectal cancer

ObjectiveTo investigate the effect of laparoscopic radical resection on gastrointestinal function, oxidative stress, and immune function in patients with colorectal cancer. MethodsA total of 113 patients with colorectal cancer admitted to Xingtai People's Hospital from January 2018 to December 2020 were prospectively selected, and randomly divided into either a laparoscopic group (n=57) or a laparotomy group (n=56) using the random number table method. The laparoscopic group received laparoscopic radical resection, while the laparotomy group underwent open radical resection. Perioperative indicators (including intraoperative blood loss, operation time, and hospital stay), recovery of gastrointestinal function after surgery, and postoperative complications were recorded preoperative. Gastrointestinal hormones [gastrin and motilin], oxidative stress indicators [superoxide dismutase (SOD) and malondialdehyde (MDA)], and immune function indexes [immunoglobulin (Ig)A, IgG, and IgM] before surgery and at 24 h and 72 h after surgery were also recorded. ResultsIntraoperative blood loss was less, and operation time and hospital stay were shorter in the laparoscopic group than in the laparotomy group (P＜0.05). The time to first exhaust and time to food intake were shorter in the laparoscopic group than in the laparotomy group (P＜0.05). The postoperative complications in the laparoscopic group were less than those of the laparotomy group (P＜0.05). The levels of gastrin and motilin at 24 h and 72 h after surgery were higher in the laparoscopic group than in the laparotomy group (P＜0.05). SOD level was higher and MDA level was lower in the laparoscopic group than in the laparotomy group at 24 h and 72 h after surgery (P＜0.05). The levels of IgA, IgG, and IgM in the laparoscopic group were higher than those in the laparotomy group at 24 h and 72 h after surgery (P＜0.05). ConclusionLaparoscopic radical resection can promote the recovery of gastrointestinal function in patients with colorectal cancer, has fewer postoperative complications, and has little effect on patients' oxidative stress and immune function.