腹腔镜结直肠癌NOSES疗效分析以及对氧化应激、炎性反应的影响

目的 探究采用腹腔镜结直肠癌标本经自然腔道取出术(natural orifice specimen extraction surgery, NOSES)治疗结直肠癌的临床疗效以及对患者氧化应激、炎症反应的影响。方法 选择2018年3月至2019年11月于南阳市第二人民医院胃肠外科接受手术治疗的134例结直肠癌患者,并根据术式不同分为2组。其中观察组67例给予腹腔镜NOSES,对照组67例采用腹腔镜结直肠癌根治术,治疗后再对比2组手术相关指标、氧化应激以及炎症反应情况。结果 观察组首次排气时间、术后住院时间分别为(26.32±3.13)h、(6.62±0.77)d,均显著低于对照组,差异有统计学意义(P<0.05);术后24 h 2组MDA均显著升高,SOD水平均显著降低,且观察组MDA升高幅度与SOD降低幅度均显著低于对照组,差异有统计学意义(P<0.05);术后24 h 2组TNF-α、CRP、IL-6水平均显著升高,IL-10水平显著降低,且观察组TNF-α、CRP、IL-6水平升高幅度与IL-10水平降低幅度显著低于对照组,差异有统计学意义(P<0.05)。结论 结直肠癌患者采用腹腔镜NOSES能够有效改善氧化应激与炎症反应,术后康复效果显著。

Analysis of the effect of laparoscopic colorectal cancer NOSES operation and its influence on oxidative stress and inflammatory response

Objective To explore the clinical effect of laparoscopic colorectal cancer natural orifice specimen extraction surgery(NOSES)in the treatment of colorectal cancer, as well as the effect on oxidative stress and inflammatory response of patients. Methods 134 patients with colorectal cancer who received surgical treatment in our hospital from March 2018 to November 2019 were divided into two groups according to different surgical procedures. Among them, 67 patients in the observation group received laparoscopic NOSES operation, 67 patients in the control group received laparoscopic colorectal cancer radical surgery. After treatment, the operation related indicators, oxidative stress and inflammatory response were compared between the two groups. Results The first exhaust time and postoperative hospitalization time of the observation group were(26.32±3.13)h and(6.62±0.77)d, respectively, which were significantly lower than those of the control group, with statistical difference(P<0.05). The MDA and SOD levels of the two groups were significantly higher and lower 24 hours after operation, and the MDA and SOD levels of the observation group were significantly lower than those of the control group, with statistical difference(P<0.05). 24 hours after operation, the two groups The levels of TNF-α, CRP and IL-6 in the observation group were significantly higher than those in the control group(P<0.05). Conclusion Laparoscopic NOSES can effectively improve oxidative stress and inflammation in patients with colorectal cancer, and the postoperative rehabilitation effect is significant, which is worthy of clinical application.