手助腹腔镜行结肠癌切除

Hand-assisted laparoscopic surgery for colon cancer resection

目的:探讨手助腹腔镜(HALS)行结肠癌根治术的临床效果。方法:将2010年1月—2011年5月住院的结肠癌患者,随机分成HALS组(21例),传统腹腔镜(LS)组(25例)和常规开腹组(24例),对其临床资料效果进行对比分析。结果:HALS组21例全部完成HALS,LS组23例完成LS,2例中转开腹,但两组中转率差异无统计学意义。HALS组较LS组平均手术时间短(153.9 min vs.171.7 min)(P=0.011)。HALS组与LS组相比术中失血量、平均住院日、总费用、术后排气时间、淋巴结清扫数目均无统计学差异(均P>0.05)。与开腹组比较,HALS组手术时间有所增加(153.9 min vs.131.8 min)(P=0.002),但术中失血量,术后排气时间,住院时间均明显缩短(均P<0.05),两组清除淋巴结数量无统计学差异。结论:HALS结肠癌根治术同样具备传统腹腔镜手术微创,安全,术后恢复快的优点,同时缩短了手术时间。

Objective： To investigate the clinical efficacy of hand-assisted laparoscopic surgery （HALS） in the radical operation of colon cancer. Methods： Patients with colon cancer admitted to our hospital from January of 2010 to May of 2011 were selected and randomly divided into the HALS group （21 cases）, conventional laparoscopic surgery （LS） group （2S cases） and open surgery group （24 cases）. The clinical results of the three groups were compared and analyzed. Results： HALS was successfully performed on all of the 21 cases of HALS group, and in LS group, LS was performed on 23 cases and 2 cases were converted to open surgery, but the conversion rates between the two groups had no statistical difference. The average operative time of the HALS group was shorter than that of the LS group （1S3.9 min vs. 171.7 min） （P=0.011）. There were no statistical differences in intraoperative blood loss, average length of hospitalization, total cost, time to first passage of gas, and number of dissected lymph nodes between the HALS and LS group （all P〉0.05）. Compared with the open surgery group, the operative time of the HALS group was somewhat prolonged （153.9 min vs. 131.8 min） （P=0.002）, but the intraoperative blood loss, time to first passage of gas, and the average length of hospital stay were markedly reduced （all P〈0.05）, and the numbers of dissected lymph nodes between the 2 groups had no obvious difference. Conclusion： HALS for radical resection of colon cancer not only has the same advantage of minimal invasion, safe and quick recovery as the conventional LS, but also shortens the operative time.