目的 探讨腹腔镜与小切口直肠癌根治术对患者机体细胞免疫功能的影响。
方法 选取2010年1月至2011年6月期间我院行腹腔镜及小切口直肠癌根治患者102例,其中腹腔镜组53例,小切口组49例。 采用流式细胞仪测定患者术前1d及术后第1及第5天外周血中CD3、CD4+、CD8+、CD19及NK细胞比例的变化,研究不同手术方式对患者细胞免疫功能的影响。
结果 术后第1及第5天,腹腔镜组和小切口组患者的CD3、CD4+、CD8+、CD19及NK细胞比例(数)均较术前明显降低(P<0.05)。同腹腔镜组比较,小切口组术前及术后CD3、CD4+、CD8+、CD19及NK细胞比例(数)的差异均无统计学意义(P>0.05)。
结论 腹腔镜与小切口直肠癌根治对患者机体细胞免疫功能的无明显影响。
Citation:
张广军,周彤. Effects of Laparoscopic and Minilaparotomy Approaches to Rectal Cancer on Cellular Immune Functions. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(1): 87-89. doi:
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范莹, 吴硕东, 于宏, 等. 腹腔镜结直肠癌根治术与同期开腹手术对比的单中心回顾性研究[J] .中国普外基础与临床杂志,2009, 16(5): 384-388.
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Huang C, Huang R, Jiang T, et al.Laparoscopic and open resection for colorectal cancer: an evaluation of cellular immunity[J]. BMC Gastroenterol, 2010, 10:127-134.
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3. |
Wichmann MW, Hüttl TP, Winter H, et al.Immunological effects of laparoscopic vs.open colorectal surgery:a prospective clinical study[J].Arch Surg, 2005, 140(7):692-697.
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4. |
胡建昆, 周总光, 陈志新. 腹腔镜结直肠癌手术对机体免疫功能的影响[J].中华胃肠外科杂志, 2004, 7(3):242-243..
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5. |
Fürstenberg S, Goldman S, Machado M, et al.Minilaparotomy approach to tumors of the right colon[J].Dis Colon Rectum,1998, 41(8):997-999.
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6. |
Fleshman JW, Fry RD, Birnbaum EH, et al.Laparoscopic-assisted and minilaparotomy approaches to colorectal diseases are similar in early outcome[J].Dis Colon Rectum, 1996, 39(1):15-22.
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7. |
Nakagoe T, Sawai T, Tsuji T, et al.Early outcome after minila-parotomy for the treatment of rectal cancer[J].Eur J Surg, 2001,167(9):705-710.
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8. |
林建江, 叶锋, 宋章法.应用小切口方法根治直肠癌[J].浙江大学学报(医学版), 2004, 33(4):357-360.
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9. |
刘畅, 罗翼, 汪晓东, 等. 老年直肠癌患者运用小切口开腹手术的机体应激反应[J]. 昆明医学院学报, 2011, 32(4): 30-35, 47.
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10. |
Ishida H, Nakada H, Yokoyama M, et al. Minilaparotomy approach for colonic cancer:initial experience of 54 cases[J].Surg Endosc, 2005, 19(3):316-320.
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11. |
Yamaguchi Y, Minami K, Kawabuchi Y, et al.Anterior resection of rectal cancer through a one hand-size incision with or without laparoscopy:proposal of one hand-size incision surgery (OHaSIS)[J].J Surg Res, 2005, 129(1): 136-141.
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12. |
D’annibale A, Morpurgo E, Fiscon V, et al.Minimally invasive resection for colorectal cancer: perioperative and medium-term results in an unselected patient group at a single institution[J].Tech Coloproctol, 2006, 10(4):303-307.
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13. |
Mehigan BJ, Hartley JE, Drew PJ, et al.Changes in T cell subsets, interleukin-6 and C-reactive protein after laparoscopic and open colorectal resection for malignancy[J].Surg Endosc, 2001, 15(11):1289-1293.
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14. |
Ordemann J, Jacobi CA, Schwenk W, et al.Cellular and humoral inflammatory response after laparoscopic and conventional colorectal resections[J].Surg Endosc, 2001, 15(6):600-608.
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15. |
Han SA, Lee WY, Park CM, et al.Comparison of immunolo-gic outcomes of laparoscopic vs. open approaches in clinical stage Ⅲcolorectal cancer[J].Int J Colorectal Dis, 2010, 25(5):631-638.
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- 1. 范莹, 吴硕东, 于宏, 等. 腹腔镜结直肠癌根治术与同期开腹手术对比的单中心回顾性研究[J] .中国普外基础与临床杂志,2009, 16(5): 384-388.
- 2. Huang C, Huang R, Jiang T, et al.Laparoscopic and open resection for colorectal cancer: an evaluation of cellular immunity[J]. BMC Gastroenterol, 2010, 10:127-134.
- 3. Wichmann MW, Hüttl TP, Winter H, et al.Immunological effects of laparoscopic vs.open colorectal surgery:a prospective clinical study[J].Arch Surg, 2005, 140(7):692-697.
- 4. 胡建昆, 周总光, 陈志新. 腹腔镜结直肠癌手术对机体免疫功能的影响[J].中华胃肠外科杂志, 2004, 7(3):242-243..
- 5. Fürstenberg S, Goldman S, Machado M, et al.Minilaparotomy approach to tumors of the right colon[J].Dis Colon Rectum,1998, 41(8):997-999.
- 6. Fleshman JW, Fry RD, Birnbaum EH, et al.Laparoscopic-assisted and minilaparotomy approaches to colorectal diseases are similar in early outcome[J].Dis Colon Rectum, 1996, 39(1):15-22.
- 7. Nakagoe T, Sawai T, Tsuji T, et al.Early outcome after minila-parotomy for the treatment of rectal cancer[J].Eur J Surg, 2001,167(9):705-710.
- 8. 林建江, 叶锋, 宋章法.应用小切口方法根治直肠癌[J].浙江大学学报(医学版), 2004, 33(4):357-360.
- 9. 刘畅, 罗翼, 汪晓东, 等. 老年直肠癌患者运用小切口开腹手术的机体应激反应[J]. 昆明医学院学报, 2011, 32(4): 30-35, 47.
- 10. Ishida H, Nakada H, Yokoyama M, et al. Minilaparotomy approach for colonic cancer:initial experience of 54 cases[J].Surg Endosc, 2005, 19(3):316-320.
- 11. Yamaguchi Y, Minami K, Kawabuchi Y, et al.Anterior resection of rectal cancer through a one hand-size incision with or without laparoscopy:proposal of one hand-size incision surgery (OHaSIS)[J].J Surg Res, 2005, 129(1): 136-141.
- 12. D’annibale A, Morpurgo E, Fiscon V, et al.Minimally invasive resection for colorectal cancer: perioperative and medium-term results in an unselected patient group at a single institution[J].Tech Coloproctol, 2006, 10(4):303-307.
- 13. Mehigan BJ, Hartley JE, Drew PJ, et al.Changes in T cell subsets, interleukin-6 and C-reactive protein after laparoscopic and open colorectal resection for malignancy[J].Surg Endosc, 2001, 15(11):1289-1293.
- 14. Ordemann J, Jacobi CA, Schwenk W, et al.Cellular and humoral inflammatory response after laparoscopic and conventional colorectal resections[J].Surg Endosc, 2001, 15(6):600-608.
- 15. Han SA, Lee WY, Park CM, et al.Comparison of immunolo-gic outcomes of laparoscopic vs. open approaches in clinical stage Ⅲcolorectal cancer[J].Int J Colorectal Dis, 2010, 25(5):631-638.