右半结肠癌合并肠梗阻行杂交手术和开放手术的短期和长期疗效对比

doi:10.3969/j.issn.1009-976X.2025.06.006

摘要/Abstract

摘要： 目的探索右半结肠癌合并肠梗阻行杂交手术和开放手术的短期和长期疗效对比。方法选取2019年6月至2022年6月因右半结肠癌合并肠梗阻接受手术治疗的92例患者,分为观察组（杂交手术,n=40）和对照组（开放手术,n=52）。比较两组围手术期指标、并发症发生率、术后1 d及4 d的炎症与营养指标,并对术后3年的总生存率进行随访对比。结果观察组手术时间显著长于对照组,但出血量、疼痛水平、首次进食、排气、住院时间均显著低于对照组（P<0.05）,而两组并发症发生率无统计学差异（P>0.05）;术后1 d、4 d时,观察组血清炎症因子水平均显著低于对照组,营养指标水平均显著高于对照组（P<0.05）;术后随访3年,两组患者的总生存率差异无统计学意义（P>0.05）。结论杂交手术耗时较长,但患者术后恢复更快,且术后炎症状态和营养水平改善更佳,两组术后30 d主要并发症发生率及长期总生存率差异均无统计学意义。

关键词: 右半结肠癌, 肠梗阻, 杂交手术, 开放手术, 短期疗效, 长期疗效

Abstract: Objective To explore and compare the short-term and long-term curative effects of hybrid surgery and open surgery on right-sided colon cancer with intestinal obstruction. Methods A total of 92 patients who underwent surgical treatment for right colon cancer with intestinal obstruction from June 2019 to June 2022 were selected and divided into an observation group （hybrid surgery, n=40） and a control group （open surgery, n=52）. Perioperative indicators, complication rates, inflammatory and nutritional markers on postoperative day 1 and day 4 were compared between the two groups. The overall survival rates at 3 years postoperatively were also followed up and compared. Results The surgical time in observation group was significantly longer than that in control group （P<0.05）, and the blood loss volume, pain level, first feeding time, exhaust time and hospitalization time were significantly less or shorter （P<0.05）. There were no statistical differences in the incidence rates of complications between the two groups （P>0.05）. At 4 days after surgery, the levels of serum inflammatory factors in observation group were significantly lower while the nutritional indexes levels were significantly higher compared to control group （P<0.05）. At 3 years of follow-up after surgery, no statistical difference was found in the overall survival rate between the two groups （P>0.05）. Conclusion Hybrid surgery takes a long time, and has fast postoperative recovery and improved postoperative inflammatory status and nutritional indexes, and there are no significant differences in the major complications at 30 days after surgery and long-term overall survival rate.

Key words: right-sided colon cancer, intestinal obstruction, hybrid surgery, open surgery, short-term curative effect, long-term curative effect

中图分类号:

杨愈刚, 罗立雄, 郑枝忠, 胡锦辉. 右半结肠癌合并肠梗阻行杂交手术和开放手术的短期和长期疗效对比[J]. 岭南现代临床外科, 2025, 25(06): 382-387.

YANG Yu-gang, LUO Li-xiong, ZHENG Zhi-zhong, HU Jin-hui. Comparison of short-term and long-term curative effects of hybrid surgery and open surgery on right-sided colon cancer with intestinal obstruction[J]. Lingnan Modern Clinics In Surgery, 2025, 25(06): 382-387.

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