摘要
目的比较腹腔镜右半结肠癌根治术三种不同手术入路的临床应用。方法收集2019年2月至2021年5月新疆医科大学附属中医医院普外科收治的124例右半结肠癌患者临床资料。按照手术方式分为完全头侧入路组28例,中间入路组52例,尾侧联合中间入路组44例。比较三组间手术时间、术中出血量、淋巴结清扫个数、术后首次排便时间、住院时间及并发症发生率。结果三组在术中出血量、淋巴结清扫个数、术后首次排便时间、住院时间及并发症发生率比较差异无统计学意义(P>0.05),但尾侧联合中间入路组在手术时间及术后首次排气时间优于其他两组,差异有统计学意义(P<0.05)。完全头侧入路组有2例发生皮下气肿,1例发生炎性肠梗阻,1例发生切口感染,1例发生肺部感染;中间入路组有2例发生皮下气肿,1例发生吻合口出血,2例发生炎性肠梗阻,2例发生切口感染,1例发生肺部感染;尾侧入路组有2例发生皮下气肿,1例发生吻合口出血,1例发生炎性肠梗阻,1例发生切口感染,1例发生肺部感染。给予保守治疗后均痊愈或好转,无一例发生致命并发症。三组在术后并发症发生率比较差异无统计学意义(P>0.05)。结论腹腔镜右半结肠癌根治术的完全头侧入路、中间入路、尾侧联合中间入路都是安全可行的,在肿瘤根治性方面无明显差异,但尾侧联合中间入路手术时间更短,操作相对容易,更易被初学者掌握,值得临床推广。
Objective To compare the clinical application of three different surgical approaches for laparoscopic radical resection of right colon cancer.Methods The clinical data of 124 patients with right colon cancer admitted to the Department of General Surgery,Affiliated Hospital of Traditional Chinese Medicine,Xinjiang Medical University from February 2019 to May 2021 were collected.According to the surgical methods,the patients were divided into complete cranial approach group(n=28),intermediate approach group(n=52)and caudal combined intermediate approach group(n=44).There was no significant difference in the baseline data among the three groups(P>0.05),with comparability.Results The differences in the intraoperative blood loss,number of dissected lymph nodes,postoperative first defecation time,hospital stay and incidence rate of complications among the three groups had no statistical significance(P>0.05),Howerer there were statisticolly significant difference in operation time and fivst exhavgt time of cavdal combined with middle approach group dve to the other two groups(P<0.05).There were 2 cases of subcutaneous emphysema,1 case of inflammatory intestinal obstruction,1 case of incision infection and 1 case of pulmonary infection in the complete cranial approach;there were 2 cases of subcutaneous emphysema,1 case of anastomotic bleeding,2 cases of inflammatory intestinal obstruction,2 cases of incision infection and 2 cases of pulmonary infection in the middle approach;there were 2 cases of subcutaneous emphysema,1 case of anastomotic bleeding,1 case of inflammatory intestinal obstruction,1 case of incision infection and 1 case of pulmonary infection in the caudal approach.All patients recovered or improved after conservative treatment,and none had fatal complications.There was no significant difference in the incidence rate of postoperative complications among the three groups(P>0.05).Conclusion The complete cranial approach,intermediate approach and caudal combined intermediate approach for laparoscopic radical r
作者
于鹏
段绍斌
YU Peng;DUAN Shao-bin(Department of General Surgery I,Affiliated Hospital of Traditional Chinese Medicine,Xinjiang Medical University(Hospital of Traditional Chinese Medicine,Xinjiang Uygur Autonomous Region)Urumqi 830011)
出处
《现代消化及介入诊疗》
2022年第6期692-696,共5页
Modern Interventional Diagnosis and Treatment in Gastroenterology
基金
新疆维吾尔自治区自然科学基金(2018D01C283)。
关键词
腹腔镜
右半结肠癌根治术
手术入路
完全头侧入路
中间入路
Laparoscopy
Radical resection of right colon cancer
Surgical approach
Complete cephalad approach
Intermediate approach
