摘要
目的:探讨经脐单孔腹腔镜在右半结肠癌根治性手术中的安全性和可行性。方法:回顾性分析2019年1月至2020年6月常熟市第二人民医院胃肠外科联合上海瑞金医院外科开展的60例腹腔镜右半结肠癌根治性手术,分为单孔法30例与传统五孔法30例。对病人的临床病例资料、手术情况、术后并发症等进行比较。结果:切口长度、术中出血量、肿瘤最大径、术后进食时间、术后拔管时间、术后住院时间、术后病理检查结果及淋巴结检出数,单孔组和五孔组比较,差异无统计学意义。单孔组与五孔组相比,手术时间[(185.17±12.28)min比(127.83±16.70)min]长,术后第1天VAS疼痛评分[(3.30±0.79)分比(3.97±0.72)分]低,术后肛门开始排气时间[(2.70±0.54)d比(3.97±0.49)d]早,差异有统计学意义(P<0.05)。单孔组术后2例切口感染,五孔组1例,差异无统计学意义(P>0.05)。两组术后各1例吻合口漏(P>0.05)。随访(11.0±0.6)个月,两组术后均无复发,差异无统计学意义(P>0.05)。结论:单孔腹腔镜右半结肠癌根治性手术在临床疗效等方面与传统五孔腹腔镜手术相似,值得临床应用。
Objective To investigate the safety and feasibility of transumbilical single-incision laparoscopy in radical operation for right colonic cancer.Methods A retrospective study was conducted in 60 patients who underwent laparoscopic radical right hemicolectomy for colonic cancer from January 2019 to June 2020 in Department of Gastrointestinal Surgery Changshu Second People’s Hospital combined with Department of Surgery Ruijin Hospital Shanghai.The patients were divided into group of single-incision laparoscopic surgery(SILS)(n=30)and group of conventional five-port laparoscopic surgery(CLS)(n=30).Patient demographics,operative details and postoperative complications were compared be-tween two groups.Results No significant differences were observed in length of incision,intraoperative blood loss,largest diameter of tumor,postoperative feeding time,extraction time of drainage tube,postoperative hospital stay,pathologic stage and lymph node harvest between SILS group and CLS group.Compared with CLS group,SILS group showed that all longer operative time[(185.17±12.28)min vs.(127.83±16.70)min],lower mean pain score(visual analog scale)[(3.30±0.79)vs.(3.97±0.72)]on the first postoperative day and earlier postoperative evacuation time[(2.70±0.54)d vs.(3.97±0.49)d]with statistical significant difference(P<0.05).There were incision infections 2 cases in SILS group and 1 case in CLS group(P>0.05).One case with postoperative anastomotic leakage in both SILS group and CLS group(P>0.05).No tumor recurrence was present in 2 groups during the period of follow-up(11.0±0.6)months.Conclusions Clinical efficacy in single-incision laparoscopy would be similar to CLS for radical resection of right colonic cancer.
作者
邵佳哲
周国强
郭健
刘坤
赵任
SHAO Jiazhe;ZHOU Guoqiang;GUO Jian;LIU Kun;ZHAO Ren(Department of Gastrointestinal Surgery,Changshu Second People’s Hospital,Jiangsu Suzhou 215500,China;Department of Surgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)
出处
《外科理论与实践》
2022年第1期70-75,共6页
Journal of Surgery Concepts & Practice
关键词
右半结肠癌
单孔腹腔镜手术
传统五孔腹腔镜手术
Right colonic cancer
Single-incision laparoscopic surgery
Conventional five-port laparoscopic surgery
