比较腹腔镜手术与传统开腹手术治疗结肠癌的临床疗效及对免疫功能的影响。

回顾性分析2014年1月至2016年6月收治的156例行结肠癌根治术的患者临床资料，分为腹腔镜组(78例，行腹腔镜下结肠癌根治术)和开腹组(78例，行开腹结肠癌根治术)，采用SPSS17.0软件进行统计学分析，手术效果相关指标、术后恢复指标及免疫功能相关指标等以(±s)表示，采用独立t检验；术后并发症发生率组间比较采用χ²检验，P<0.05为差异有统计学意义。

在手术效果方面，腹腔镜组患者术中出血量和切口长度明显少(短)于开腹组(P<0.05)；两组患者手术时间、淋巴结清扫数目、切除病变肠管长度差异均无统计学意义(均P>0.05)。在术后恢复方面，腹腔镜组术后镇痛时间、首次通气时间、术后下床活动时间以及平均住院时间均明显少于开腹组(均P<0.05)；两组患者术后并发症发生率比较，差异无统计学意义(P>0.05)。两组患者术前免疫指标比较，差异无统计学意义(P>0.05)；术后两组患者外周血淋巴细胞亚群(CD3^＋、CD4^＋、CD⁴＋/CD8^＋)、免疫球蛋白(IgA、IgG、IgM)水平明显降低，CD8^＋、C反应蛋白(CRP)和白介素－6(IL－6)明显升高(均P<0.05)；腹腔镜组免疫相关指标明显优于开腹组，差异均具有统计学意义(均P<0.05)。

腹腔镜下治疗结肠癌是安全可行的，具有术中出血少、术后恢复快的优势，且对机体免疫系统影响较小。

To compare the clinical efficacy and impacts on immune function of laparoscopic and open surgery in treatment of colorectal cancer.

From January 2014 to June 2016, clinical data of 156 patients with colorectal cancer were analyzed retrospectively, including 78 cases in laparoscopy group and 78 cases in laparotomy group. Clinical data were analyzed by using statistical software SPSS 17.0. Measurement data such as operation effect indicators, post-operative recovery indicators and immune function related indicators were expressed as mean±standard deviation, and were examined by using t test. Count data, such as postoperative complication rate, were expressed as % , and were examined by using χ² test. A P value <0.05 was considered as statistically significant difference.

In the aspect of operation effect indicators: the length of incision, intraoperative blood loss in laparoscopy group were significantly less (shorter) than those of the laparotomy group (P<0.05); There were no significant differences in terms of operation time, number of harvested lymph nodes and length of resected bowel between the two groups (P>0.05). In terms of post-operative recovery indicators: the analgesia time, first flatus time, groud activity time and the average hospitalization time in laparoscopy group were significantly less than those of the laparotomy group (P<0.05); There was no significant differences of post-operative complication rate between 2 groups (P>0.05). There was no significant difference of immune function related indicators between the two groups before operation. The levels of CD3⁺ , CD4⁺ , CD4⁺ /CD8⁺ were significantly lower, CD8⁺ , CRP, IL-6 were significantly higher after operation (P<0.05). The immune related indicators in laparoscopy group were significantly better than those in laparotomy group (P<0.05).

Laparoscopic in the treatment of patients with colorectal cancer is feasible and safe, and has the benefits of less intraoperative blood loss, quicker postoperative recovery, exerts a less negative influence on the immune system compared with open surgery.