• 川北醫(yī)學(xué)院附屬醫(yī)院普外一科,肝膽胰腸研究所(四川南充 637000);

目的  探討腹腔鏡與小切口直腸癌根治術(shù)對(duì)患者機(jī)體細(xì)胞免疫功能的影響。
方法  選取2010年1月至2011年6月期間我院行腹腔鏡及小切口直腸癌根治患者102例,其中腹腔鏡組53例,小切口組49例。 采用流式細(xì)胞儀測(cè)定患者術(shù)前1d及術(shù)后第1及第5天外周血中CD3、CD4+、CD8+、CD19及NK細(xì)胞比例的變化,研究不同手術(shù)方式對(duì)患者細(xì)胞免疫功能的影響。
結(jié)果  術(shù)后第1及第5天,腹腔鏡組和小切口組患者的CD3、CD4+、CD8+、CD19及NK細(xì)胞比例(數(shù))均較術(shù)前明顯降低(P<0.05)。同腹腔鏡組比較,小切口組術(shù)前及術(shù)后CD3、CD4+、CD8+、CD19及NK細(xì)胞比例(數(shù))的差異均無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)。
結(jié)論  腹腔鏡與小切口直腸癌根治對(duì)患者機(jī)體細(xì)胞免疫功能的無(wú)明顯影響。

引用本文: 張廣軍,周彤. 腹腔鏡與小切口直腸癌根治術(shù)對(duì)機(jī)體細(xì)胞免疫功能影響的對(duì)比研究. 中國(guó)普外基礎(chǔ)與臨床雜志, 2012, 19(1): 87-89. doi: 復(fù)制

1.  范瑩, 吳碩東, 于宏, 等. 腹腔鏡結(jié)直腸癌根治術(shù)與同期開(kāi)腹手術(shù)對(duì)比的單中心回顧性研究[J] .中國(guó)普外基礎(chǔ)與臨床雜志,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, 周總光, 陳志新. 腹腔鏡結(jié)直腸癌手術(shù)對(duì)機(jī)體免疫功能的影響[J].中華胃腸外科雜志, 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, 葉鋒, 宋章法.應(yīng)用小切口方法根治直腸癌[J].浙江大學(xué)學(xué)報(bào)(醫(yī)學(xué)版), 2004, 33(4):357-360.
9. 劉暢, 羅翼, 汪曉東, 等. 老年直腸癌患者運(yùn)用小切口開(kāi)腹手術(shù)的機(jī)體應(yīng)激反應(yīng)[J]. 昆明醫(yī)學(xué)院學(xué)報(bào), 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?、骳olorectal cancer[J].Int J Colorectal Dis, 2010, 25(5):631-638.
  1. 1.  范瑩, 吳碩東, 于宏, 等. 腹腔鏡結(jié)直腸癌根治術(shù)與同期開(kāi)腹手術(shù)對(duì)比的單中心回顧性研究[J] .中國(guó)普外基礎(chǔ)與臨床雜志,2009, 16(5): 384-388.
  2. 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. 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. 4. 胡建昆, 周總光, 陳志新. 腹腔鏡結(jié)直腸癌手術(shù)對(duì)機(jī)體免疫功能的影響[J].中華胃腸外科雜志, 2004, 7(3):242-243..
  5. 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. 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. 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. 8. 林建江, 葉鋒, 宋章法.應(yīng)用小切口方法根治直腸癌[J].浙江大學(xué)學(xué)報(bào)(醫(yī)學(xué)版), 2004, 33(4):357-360.
  9. 9. 劉暢, 羅翼, 汪曉東, 等. 老年直腸癌患者運(yùn)用小切口開(kāi)腹手術(shù)的機(jī)體應(yīng)激反應(yīng)[J]. 昆明醫(yī)學(xué)院學(xué)報(bào), 2011, 32(4): 30-35, 47.
  10. 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. 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. 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. 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. 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. 15. Han SA, Lee WY, Park CM, et al.Comparison of immunolo-gic outcomes of laparoscopic vs. open approaches in clinical stage?、骳olorectal cancer[J].Int J Colorectal Dis, 2010, 25(5):631-638.