Abstract:Objective: To study clinical effect of laparoscopy in rectal cancer and its effect on the third space effect. Methods: 95 cases of rectal cancer patients received in our hospital from December 2014 to December 2017 were selected as subjects, the randomized table method was divided into the observation group (n=50) and the control group (n=45). The control group was treated by laparotomy and the observation group by laparoscopic rectal cancer resection. The operation time, intraoperative blood loss, number of lymph nodes dissection, time of first ventilation, time of getting out of bed, time of hospitalization, serum albumin, total protein, anterior albumin, electrolyte, fluid inflow and outflow, complications and patient satisfaction were compared between the two groups. Results: There was no significant difference in the number of lymph node dissection between the two groups. The operation time of the observation group was higher than that of the control group, and the intraoperative blood loss, time of first ventilation, time of out of bed activity and time of hospitalization were significantly lower than that of the control group (P<0.05). There was no significant difference in postoperative Na+, K+, Ca+ and protein levels between the two groups (P>0.05). The fluid volume and difference between the two groups were statistically significant (P<0.05). The total incidence of complications was 6.00% in the observation group, significantly lower than 28.89% in the control group. The patient satisfaction of the observation group was 98.00%, significantly higher than that of the control group (P<0.05). Conclusion: In patients with rectal cancer, the third space effect after laparotomy and laparotomy is abnormal in different degrees. However, laparotomy with laparotomy can reduce hospitalization time and complications, and the patient satisfaction is high, which is worthy of promotion and application.
罗亮, 彭方兴, 吴宸, 陈汇. 减孔腹腔镜治疗直肠癌的临床效果及对第三间隙效应的影响[J]. 河北医学, 2019, 25(4): 658-662.
LUO Liang, PENG Fangxing, WU Chen, et al. Clinical Effect of Laparoscopy in Rectal Cancer and its Effect on the third Space Effect. HeBei Med, 2019, 25(4): 658-662.
[1] 张庆彤,刘亚莉,张旭,等.减孔与多孔腹腔镜手术治疗直肠癌临床疗效对比研究[J].中国实用外科杂志,2017,37(3):276~280. [2] Lin J S, Piper M A, Perdue L A, et al. Screening for colorectal cancer: updated evidence report and systematic review for the US preventive services task force.[J]. Jama, 2016, 315(23):2576~2594. [3] 胡跃,张苏展.结直肠癌诊治指南热点解读[J].中国实用外科杂志,2011,31(06):473~475. [4] Mlecnik B, Bindea G, Angell H K, et al. Integrative analyses of colorectal cancer show immunoscore is a stronger predictor of patient survival than microsatellite instability.[J]. Immunity, 2016, 44(3):698~711. [5] 黄甫达,杨昌谋,郭俊宇,等.腹腔镜直肠癌根治术与Dixon直肠癌根治术的临床疗效对比[J].世界华人消化杂志,2014,22(2):291~295. [6] 熊懿.腹腔镜直肠全系膜切除术治疗中、低位直肠癌的临床疗效分析[J].中国普通外科杂志,2015,24(4):616~618. [7] Elshami K, Oeffinger K C, Erb N L, et al. American cancer society colorectal cancer survivorship care guidelines[J]. Ca A Cancer Journal for Clinicians, 2016, 65(6):427~455.