腹腔镜右下象限方法治疗右侧结肠癌具有手术时间短、失血少等优势。

IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE
Xu Zhang, Chuanxin Zhang, Xin Zheng, Anqi Xu, Peng Chen
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引用次数: 0

摘要

研究目的本研究旨在比较腹腔镜下右下象限和中线入路治疗右侧结肠癌的疗效,并评估帕瑞昔布钠的镇痛效果:选取2019年1月至2022年11月期间临颍县人民医院收治的60例右侧结肠癌患者。他们被分为研究 A 组(30 人)和研究 B 组(30 人),研究 A 组采用右下腹入路,研究 B 组采用中线入路。所有患者均接受帕瑞昔布钠治疗。对两组患者的手术时间、失血量、术后并发症及其他相关指标进行记录和比较。此外,研究组和对照组的镇痛效果也进行了比较,对照组有60名右侧结肠癌患者,他们在同一时期接受了传统的非排异镇痛腹腔镜手术:手术时间(RR = 0.608,95%CI 0.51,1.53,P = .042)、失血量(RR = 0.798,95%CI 0.52,1.02,P < .001)、肠功能恢复时间(RR = 0.808,95%CI 0.50,1.77,P = .007)和住院时间(RR = 0.766,95%CI 0.56,1.72,P =.052)明显低于 B 组,而 A 组的淋巴结清扫次数更高(RR = 0.803,95%CI 0.62,1.52,P = .047)。术后肿瘤特异性生长因子(TSGF)(RR = 0.710,95%CI 0.50,1.55,P < .001)和癌胚抗原(CEA)(RR = 0.803,95%CI 0.62,1.52,P < .001)水平在A组和B组均显著下降,组间差异不显著(P > .05)。A 组的并发症发生率明显低于 B 组(RR = 0.167,95%CI 0.17,0.63,P = .044)。研究组术后 2/4/6/8 小时的 VAS 评分明显低于对照组(RR = 0.702,95%CI 0.52,1.62,P < .001)。研究组的 SF-36 评分明显高于对照组(RR = 0.753, 95%CI 0.56, 1.82, P < .001):腹腔镜右下象限方法治疗右侧结肠癌具有手术时间短、失血少等优势。结论:腹腔镜右下象限方法治疗右侧结肠癌具有手术时间短、失血少等优点,临床疗效显著,并能降低术后并发症的发生率。帕瑞昔布钠可增强术后镇痛效果,有效减轻患者疼痛,促进康复,提高生活质量。值得在临床实践中推广。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Laparoscopic Right-lower Quadrant Approach for the Treatment of Right-sided Colon Cancer Offers Advantages Such as Shorter Surgical Time and Less Blood Loss.

Objective: This study aims to compare the therapeutic efficacy of laparoscopic right-lower quadrant and midline approaches for the treatment of right-sided colon cancer and evaluate the analgesic effect of parecoxib sodium.

Methods: Sixty patients with right-sided colon cancer admitted to Hospital of Lin 'an District between January 2019 and November 2022 were selected. They were divided into the study group A (n=30) with a right-lower quadrant approach and the study group B (n=30) with a midline approach. All patients received parecoxib sodium. Surgical time, blood loss, postoperative complications, and other relevant indicators were recorded and compared between the two groups. Additionally, a control group of 60 right-sided colon cancer patients who underwent conventional non-exclusive analgesic laparoscopic surgery during the same period was included to compare the analgesic effects between the study and control groups.

Results: The surgical time (RR = 0.608, 95%CI 0.51, 1.53, P = .042), blood loss (RR = 0.798, 95%CI 0.52, 1.02, P < .001), time for bowel function recovery (RR = 0.808, 95%CI 0.50, 1.77, P = .007), and length of hospital stay (RR = 0.766, 95%CI 0.56, 1.72, P =.052) were significantly lower in group A than in group B, while the number of lymph node dissections was higher in group A (RR = 0.803, 95%CI 0.62, 1.52, P = .047). The postoperative levels of tumor-specific growth factor (TSGF) (RR = 0.710, 95%CI 0.50, 1.55, P < .001) and carcinoembryonic antigen (CEA) (RR = 0.803, 95%CI 0.62, 1.52, P < .001) were significantly decreased in both groups A and B, with no significant difference between the groups (P > .05). The incidence of complications in group A was significantly lower than in group B (RR = 0.167, 95%CI 0.17, 0.63, P = .044). The VAS scores of the study group at 2/4/6/8 hours postoperatively were significantly lower than those of the control group (RR = 0.702, 95%CI 0.52, 1.62, P < .001). The SF-36 scores of the study group were significantly higher than those of the control group (RR = 0.753, 95%CI 0.56, 1.82, P < .001).

Conclusions: The Laparoscopic right-lower quadrant approach for the treatment of right-sided colon cancer offers advantages such as shorter surgical time and less blood loss. It demonstrates significant clinical efficacy and reduces the incidence of postoperative complications. Parecoxib sodium enhances postoperative analgesic effect, effectively alleviating patient pain, promoting recovery, and improving quality of life. It is worth promoting in clinical practice.

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来源期刊
Alternative therapies in health and medicine
Alternative therapies in health and medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-
CiteScore
0.90
自引率
0.00%
发文量
219
期刊介绍: Launched in 1995, Alternative Therapies in Health and Medicine has a mission to promote the art and science of integrative medicine and a responsibility to improve public health. We strive to maintain the highest standards of ethical medical journalism independent of special interests that is timely, accurate, and a pleasure to read. We publish original, peer-reviewed scientific articles that provide health care providers with continuing education to promote health, prevent illness, and treat disease. Alternative Therapies in Health and Medicine was the first journal in this field to be indexed in the National Library of Medicine. In 2006, 2007, and 2008, ATHM had the highest impact factor ranking of any independently published peer-reviewed CAM journal in the United States—meaning that its research articles were cited more frequently than any other journal’s in the field. Alternative Therapies in Health and Medicine does not endorse any particular system or method but promotes the evaluation and appropriate use of all effective therapeutic approaches. Each issue contains a variety of disciplined inquiry methods, from case reports to original scientific research to systematic reviews. The editors encourage the integration of evidence-based emerging therapies with conventional medical practices by licensed health care providers in a way that promotes a comprehensive approach to health care that is focused on wellness, prevention, and healing. Alternative Therapies in Health and Medicine hopes to inform all licensed health care practitioners about developments in fields other than their own and to foster an ongoing debate about the scientific, clinical, historical, legal, political, and cultural issues that affect all of health care.
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