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目的探讨腹腔镜与开腹直肠癌根治术对腹腔脱落肿瘤细胞的影响差异。方法选取2012年8月至2014年8月信阳市中心医院收治的70例直肠癌患者作为研究对象,根据术式不同分为腹腔镜组和开腹组,观察比较2组肠腔灌液内肿瘤脱落细胞阳性检出率及癌胚抗原(CEA)水平差异。结果腹腔镜组阳性检出率28.6%;开腹组阳性检出率60.0%,2组阳性检出率对比差异有统计学意(P<0.05)义。腹腔镜组CEA水平显著低于对照组(P<0.05),对比有显著性差异。结论相比于开腹术,腹腔镜直肠癌术术后肿瘤脱落细胞发生率、CEA水平更低,具有更强的可行性和优越性。不过,腹腔镜直肠癌根治术前需先进行有效的肠腔灌洗。
Objective To investigate the difference between laparoscopic and open radical resection of rectal cancer on peritoneal tumor cells. Methods Seventy patients with rectal cancer admitted to Xinyang Central Hospital from August 2012 to August 2014 were selected as study subjects and divided into laparoscopic group and laparotomy group according to different surgical procedures. The positive rate of exfoliated cells and the difference of carcinoembryonic antigen (CEA) levels. Results The positive rate of laparoscopy was 28.6%. The positive rate of laparoscopy was 60.0%. There was significant difference between the two groups (P <0.05). The level of CEA in laparoscopic group was significantly lower than that in control group (P <0.05), and the difference was significant. Conclusions Compared with laparotomy, the incidence of tumor exfoliated cells after laparoscopic surgery for rectal cancer is lower and CEA level is lower, which is more feasible and superior. However, laparoscopic rectal cancer prior to the need for effective intestinal irrigation.