手辅式腹腔镜右半结肠癌根治术在老年肥胖患者中的应用

Application of hand-assisted laparoscopic right hemicolectomy in aged obesity patients with right colon carcinoma

目的评价手辅式腹腔镜右半结肠癌根治术在老年肥胖患者中的应用价值。方法回顾分析我院行手辅式腹腔镜右半结肠癌根治术的老年肥胖患者20例,以及同期开腹右半结肠癌根治术患者25例,并进行两组比较。结果两组均无手术死亡病例,均行一期吻合;手辅式腹腔镜组术中出血量少、术后体温恢复快、排气早、术后住院时间短、与开腹组相比差异有显著性意义(P<0.01);手辅式腹腔镜组手术时间与开腹组差异无显著性意义;手辅式腹腔镜组手术切除标本长度、清扫淋巴结总数及术后并发症与开腹组比较均无显著性差异。结论手辅式腹腔镜右半结肠癌根治术应用于老年肥胖患者,具侵袭性小、操作安全可行、术后恢复快等优点,是一种较为理想的微创手术方式。

Objective To evaluate the efficiency and safety of hand-assisted laparoseopic right hemi- colectomy in aged obesity patients with right colon carcinoma. Methods Clinical data of twenty aged obesity patients undergoing hand-assisted laparoseopic right hemicolectomy were retrospectively reviewed, analyzed and compared with those of the control group of twenty-five aged obesity patients who underwent open right hemi- colectomy during the same period. Results In the hand-assisted laparoscopic group, the patients had less blood-loss, earlier normalization of temperature, recovery of bowel movement and return to normal activity, shorter post-operation hospital stay compared with the control group. The differences of operation time and post-operation complications between two groups were of no statistical significance. Conclusion Hand-assisted laparoscopic approach is a safe and efficient surgical procedure for aged obesity patients with right colon cancer.