探讨中间尾侧联合入路腹腔镜系膜切除对右半结肠癌并肠梗阻患者炎症与应激反应的影响。

回顾性分析2023年8月至2024年8月138例右半结肠癌并肠梗阻患者临床资料，根据手术入路不同分为对照组与研究组，每组各69例。对照组患者术中接受传统头侧中间入路，研究组患者术中接受中间尾侧联合入路。采用统计软件SPSS 23.0分析数据。计量资料以（±s）描述，采用t检验，计数资料以百分比（%）描述，采用χ²检验，比较两组患者手术指标，手术前后炎症因子、应激反应及并发症情况。P<0.05为差异有统计学意义。

研究组患者术中出血量、手术时间均低于对照组（P<0.05）；手术后两组患者血清C反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、去甲肾上腺素（NE）、肾上腺素（AD）、皮质醇（Cor）水平较术前均升高，且研究组上述指标低于对照组（P<0.05）；两组患者术后不良并发症发生率比较（2.9% vs.1.4%）无明显差异（P>0.05）。

右半结肠癌并肠梗阻患者应用中间尾侧联合入路腹腔镜系膜切除可有效降低患者术后机体的炎症水平与应激反应，可加速患者术后康复进程，临床应用价值高。

To explore the effect of laparoscopic mesenteric resection via the combined median-caudal approach on inflammatory and stress responses in patients with right-sided colon cancer complicated by intestinal obstruction.

A retrospective analysis was conducted on the clinical data of 138 patients with right-sided colon cancer complicated by intestinal obstruction who were treated from August 2023 to August 2024. According to the different surgical approaches, the patients were divided into a control group and a study group, with 69 cases in each group. Patients in the control group received the traditional cranial-median approach during surgery, while those in the study group received the combined median-caudal approach. Statistical software SPSS 23.0 was used for data analysis. Measurement data were described as(±s) and analyzed by t test; count data were described as percentages (%) and analyzed by χ² test. Surgical indicators, inflammatory factors, stress responses (before and after surgery), and complications were compared between the two groups. P<0.05 was considered statistically significant.

The intraoperative blood loss and operation time of the study group were lower than those of the control group (P<0.05). After surgery, the serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), norepinephrine (NE), adrenaline (AD), and cortisol (Cor) in both groups were higher than those before surgery, and the above indicators in the study group were lower than those in the control group (P<0.05). There was no significant difference in the incidence of postoperative adverse complications between the two groups (2.9% vs. 1.4%, P>0.05).

For patients with right-sided colon cancer complicated by intestinal obstruction, laparoscopic mesenteric resection via the combined median-caudal approach can effectively reduce the postoperative inflammatory level and stress response of the body, accelerate the postoperative recovery process of patients, and has high clinical application value.