腹腔镜下中间入路右半结肠癌D3根治术的临床应用

The clinical application of the D3 radical operation with the laparoscopic intermediate approach for the right colon cancer

目的观察腹腔镜下中间入路右半结肠癌D3根治术临床应用的可行性和安全性。方法将本院收治的120例结肠癌患者随机分为观察组60例和对照组60例。对照组行传统开腹手术,观察组行腹腔镜下中间入路右半结肠癌D3根治术,观察两组的手术相关指标、肿瘤根治性指标、术后并发症情况。结果观察组平均术中出血量少于对照组(P<0.05),观察组平均手术时间、肠道排气时间、恢复流质饮食时间、住院时间均短于对照组(P<0.05)。观察组平均手术切除标本长度、淋巴结清扫数目与对照组比较,差异无统计学意义(P>0.05)。观察组术后并发症的发生率为13.33%,对照组为31.67%,两组比较,差异有统计学意义(P<0.01)。结论腹腔镜下中间入路右半结肠癌D3根治术能有效减少手术出血量,缩短手术时间、肠道排气时间、恢复流质饮食时间、住院时间,其肿瘤根治效果好,术后并发症少,具有良好的可行性和安全性。

Objective To observe the feasibility and safety of the clinical application of the D3 radical operation with the laparoscopic intermediate approach for the right colon cancer. Methods 120 cases with the right colon cancer patients in our hospital were divided randomly into the observation group （60 cases）and the control group （60 cases）.The control group underwent the conventional laparotomy while the observation group underwent the D3 radical operation with the laparoscopic intermediate approach for the right colon cancer.The related index of operation,the tumor radical index and the postoperative complications of the two groups were observed. Results The average intraoperative bleeding of the observation group was less than the control group （P 0.05）. The average operation time,the intestinal exhaust time, recovery liqid diet time and the hospital time of the observation group were shorter than the control group （P 0.05）. Compared with the control group,the average operation resection specimen length,the number of lymph node dissection of the observation group had no statistical difference （ P 0.05）.Patients in the observation group the incidence of postoperative complications was 13.33%,control group 31.67%.Comparing the 2 groups, the difference was significant （P 0.01）. Conclusion The D3 radical operation with the laparoscopic intermediate approach for the right colon cancer can effectively reduce the operation bleeding;shorten the operation time,intestinal exhaust time, recovery liqid diet time and the hospital time. It has good feasibility and safety and its radical effect of the tumor is good with less postoperative complications.