摘要
目的:探究腹腔镜尾侧中间联合入路结合保护性肺通气对结肠癌患者预后的影响。方法:收集2019年4月—2021年4月期间在我院住院并接受腹腔镜完整结肠系膜切除术(CME)治疗的右半结肠癌患者62例,据手术入路不同分为两组,观察组与参照组,各31例患者。参照组以传统中间入路术式治疗,观察组则以尾侧中间联合入路结合肺保护性通气策略(LPVS)治疗。比对两组术中、术后临床指标,并发症发生率,随访的预后效果。结果:观察组淋巴结清扫数量高于参照组(P<0.05),观察组术中出血量、手术时间均小于参照组(P<0.05);观察组并发症发生率为9.68%,低于参照组的22.58%(P<0.05);观察组总生存率为96.77%、无瘤生存率为93.55%,均高于参照组总生存率的80.65%、无瘤生存率的77.42%(P<0.05)。结论:右半结肠癌患者以腹腔镜尾侧中间联合入路CME结合保护性肺通气治疗的预后效果显著,优势为术中出血量少、淋巴结清扫数量多、手术时间短、安全性高,且联合LPVS能有效规避术后肺部相关并发症,值得推广。
Objective:To explore the effect of laparoscopic caudal intermediate combined approach combined with protective lung ventilation on the prognosis of patients with colon cancer.Methods:A total of 62 patients with right colon cancer who underwent laparoscopic complete mesenteric resection(CME)in our hospital from April 2019 to April 2021 were collected and divided into two groups according to different surgical approaches,observation group and reference group,with 31 patients in each group.The control group was treated with traditional intermediate approach,while the observation group was treated with caudal intermediate combined approach combined with lung protective ventilation strategy(LPVS).The two groups were compared with intraoperative and postoperative clinical indicators,the incidence of complications and the prognosis of follow-up.Results:The number of lymph node dissection in the observation group was higher than that in the reference group(P<0.05),the amount of intraoperative blood loss and operation time in the observation group were lower than that in the reference group(P<0.05).The complication rate of observation group was 9.68%,which lower than that of reference group 22.58%(P<0.05).The overall survival rate(96.77%)and disease-free survival rate(93.55%)in the observation group were higher than those in the control group(80.65%)and disease-free survival rate(77.42%)(P<0.05).Conclusion:Laparoscopic caudal intermediate combined approach with CME combined with protective lung ventilation has significant prognostic effect in patients with right colon cancer,with advantages of less intraoperative blood loss,more lymph node dissection,short operation time and high safety.In addition,combined with LPVS can effectively avoid postoperative pulmonary complications,which is worthy of promotion.
作者
蒋海华
卢锋
李朝争
贺赛奇
Jiang Haihua(Department of Gastrointestinal Surgery,Hengyang Central Hospital,Hengyang Hunan 421000)
出处
《黑龙江医药》
CAS
2022年第4期772-775,共4页
Heilongjiang Medicine journal
基金
衡阳市2019年指导性项目(36)(项目编号:2019jh011131)。
关键词
右半结肠癌
腹腔镜
尾侧中间联合入路
保护性肺通气
预后
Right Colon Cancer
Laparoscope
Caudal Intermediate Combined Approach
Protective Lung Ventilation
The Prognosis
