Analysis of the effect of laparoscopic surgery for colorectal cancer through lateral and intermediate approaches based on enteric nerve response and nutritional status
- VernacularTitle:基于肠神经反应及营养状况分析侧方入路与中间入路腹腔镜手术治疗结直肠癌的效果
- Author:
Huadong HUANG
1
;
Baoyun HAN
;
Pengqiang BAI
Author Information
- Publication Type:Journal Article
- Keywords: colorectal cancer(CRC); laparoscopic surgery; lateral approach; intermediate approach; enteric nerve response; nutritional status
- From: China Journal of Endoscopy 2025;31(10):68-75
- CountryChina
- Language:Chinese
- Abstract: Objective To analyze the effect of laparoscopic surgery for colorectal cancer(CRC)through lateral and intermediate approaches based on enteric nerve response and nutritional status.Methods The research subjects were selected from 118 CRC patients who received treatment from February 2021 to March 2024,and their clinical data were retrospectively analyzed.They were divided into the group A(60 cases)and the group B(58 cases),with grouping based on surgical approach.Laparoscopic radical resection of CRC by the lateral approach was performed in the group A,and in the middle group,laparoscopic radical resection of CRC was performed by the middle approach.Both groups were followed up for 1 month.Postoperative indexes,gastrointestinal function recovery,intestinal nerve response and nutritional status before and 1 month after operation,surgical complications and vascular injury during follow-up were compared between the two groups.Results Compared with the group A,the group B had significantly shorter surgical time,analgesia time,hospitalization time,bowel sounds recovery time,feeding time,and anal exhaust time.Intraoperative bleeding was significantly reduced,and the number of lymph node dissection scans was significantly increased,with statistically significant differences(P<0.05).Compared with before surgery,the levels of serum vasoactive intestinal peptide(VIP),epidermal growth factor(EGF),and substance P(SP)in both groups of patients were significantly reduced 1 month after surgery,and the group B was significantly lower than the group A,with statistically significant differences(P<0.05).Compared with before surgery,the levels of serum hemoglobin(Hb),prealbumin(PAB),albumin(Alb),retinol-binding protein(RBP),transferrin(TFN)levels,and prognostic nutritional index(PNI)of both groups of patients were significantly reduced 1 month after surgery,but the group B was significantly higher than the group A,and the differences were statistically significant(P<0.05).During the follow-up period,the total incidence of surgical complications and vascular injury rate in the group B were 3.45%and 0.00%,respectively,which were lower than those in the group A(20.00%and 10.00%),and the differences were statistically significant(P<0.05).Conclusion Compared with the lateral approach,laparoscopic surgery performed through the middle approach can significantly reduce intraoperative bleeding,shorten the duration of surgery,analgesia,and hospitalization,increase lymph node dissection,and effectively promote postoperative gastrointestinal function recovery in CRC patients,improve intestinal nerve response and nutritional status,reduce vascular damage,and have high safety.
