Laparoscopic Radical Resection for the Treatment of Vascular Variant Distal Sigmoid Colon and Rectal Cancer
Gong Qing-hao,Zhang Jie,Chen Hai-qun
Department of General Surgery, Chongming Branch of Shanghai Xinhua Hospital, Shanghai 202150, China
Abstract:
Objective To explore the treatment of vascular variants of distal sigmoid colon and rectal cancer with laparoscopic radical resection and to provide clinical guidance. Methods A retrospective selection of 120 patients with distal sigmoid colon cancer and rectal cancer with vascular variants were selected as the research objects. According to the different surgical methods, the above-mentioned patients were divided into laparotomy group (58 cases) and laparoscopic group (62 cases). Laparotomy group underwent laparotomy for radical resection of colorectal cancer, and laparoscopic group underwent laparoscopic radical resection of colorectal cancer. The operation time, blood loss, length of hospitalization, gastrointestinal hormone levels, treatment effects and postoperative stomach in the two groups as well as recovery of bowel function were all analyzed. Results There was no statistically significant difference in the operation time between the two groups of patients (P>0.05), but the bleeding volume [(136.58±62.26) mL] and hospitalization time [(12.78±1.73) d] of the patients in the laparoscopic group during the operation were significantly less than those of the open group [(188.24±72.21) mL/(20.67±1.52) d] (P<0.05). In addition, the postoperative exhaust time [(1.27±0 . 43 ) d], defecation time [( 3 . 45 ±0 . 86 ) d] and bowel sound recovery time [(0.63±0.58) d] in the open-abdominal group were more than those in the laparoscopic group [(3.24±1.24) d, [(5.25±1.43) d, (1.85±0.69) d] (P<0.05). There was no significant difference between motilin and gastrin in the open group and the laparoscopic group 24h before the operation (P>0.05). The gastric motility of the two groups was 96h after the operation. Both gastrin and gastrin decreased to varying degrees, but the decrease was more signi?cant in the laparotomy group (P<0.05). At the same time, the total incidence of incision infection, anastomotic bleeding, lung infection, abdominal abscess, nausea and vomiting in the laparoscopic group (5.00%) were lower than those in the open group (13.79%) (P<0.05). Conclusion Laparoscopic radical resection of colorectal cancer has good feasibility and safety for patients with distal sigmoid colon cancer and rectal cancer with vascular variation. It can reduce the trauma of the patient' s abdomen, reduce the incidence of complications and help maintain the patient' s serum. The relative balance of motilin and gastrin promotes the recovery of gastrointestinal function after surgery which the clinical effect is good.
