手辅助腹腔镜与开腹左半结肠切除术对照研究

A comparative study of hand-assisted laparoscopic versus open left colonic resection

目的探讨手辅助腹腔镜（HALS）左半结肠切除术的安全性、可行性。方法将住院的50例结肠癌患者随机分为HALS组（25例）和开腹组（25例）两组，比较两组的手术时间、术中出血量、淋巴结清扫、术后肛门排气时间、术后住院时间、术后并发症及C反应蛋白的变化。结果HALS组术中出血量少于开腹组[（83．16．4-27．61）ml比（196．76±59．47）ml，P〈0．05]；术后肛门排气时间短于开腹组[（45．78±11．62）h比（74．08±16．12）h，P〈0．05]；术后住院时间短于开腹组[（8．24±2．46）d比（11．63±3．07）d，P〈0．05]；术后6dC反应蛋白少于开腹组[（21．68±6．97）比（67．32±28．31），P〈0．05]。结论手辅助腹腔镜左半结肠切除安全有效，具有创伤小、术后恢复快等优点。

Objective To study the safety and invasiveness of hand-assisted laparoscopic left co- Ionic resection （HALS）. Methods fifty patients undergoing left colonic resection were assigned randomly to HALS group and open group. Data of patients of two groups, Which included operating time, intraopera- tive blood, lymph node harvests, postoperative flatus time, hospital stay, complications and C-reactive pro- tein were compared. Results The mean intraoperative blood loss in HALS group was less than that in open left colonic resection group [ （83.16±27.61 ） ml vs （ 196. 76±59.47） ml P 〈0. 05] ; postoperative flatus time, hospital stay in HALS group was shorter than in open left colonic resection group [ （45. 78±11.62） h vs （74.08±16. 12） h P〈0.05], [ （8.24±2.46） d vs （11.63±3.07） d P 〈0.05] ; C-re- active protein on the sixth day in HALS group was lower than that in open left colonic resection group after operation [ （21.68±6. 97） vs （67. 32 ±28. 31 ） P 〈0. 05] ; but there was no significant difference in op- erating time, complication and recurrence rate. Conclusion HALS left colonic resection resulted in an earlier recovery after surgery. The HALS approach should be preferred to open surgery.