腹腔镜内侧入路右半结肠癌根治术与开腹手术的对照研究

Comparison of laparoscopic right hemicolectomy through medial access and open surgery for colon carcinoma

目的对比腹腔镜内侧入路右半结肠切除术和开放右半结肠切除术的临床效果。方法分析同期行腹腔镜内侧入路右半结肠切除术30例(腔镜组)和行传统开放右半结肠切除术(开腹组)27例的临床资料,比较两组的手术时间、术中出血量、清除淋巴结数、术后肛门排气时间、术后住院时间、术后并发症等指标。结果两组的手术时间、清除淋巴结数及术后并发症发生率差异无统计学意义;腔镜组的出血量(47.1±45.8)ml明显少于开腹组(90.3±50.7)ml(P<0.05);术后肛门排气时间腔镜组(24.3±7.9)h小于开腹组(63.2±16.1)h(P<0.05);术后住院时间腔镜组(7.1±1.2)d短于开腹组(12.5±2.8)d(P<0.05)。结论腹腔镜内侧入路右半结肠癌根治术安全有效,符合微创手术切口小、患者痛苦轻、康复快的优点及肿瘤根治原则。

Objective To compare the clinical efficiency of laparoscopic right hemieolectomy through medial access with conventional open right hemicolectomy. Methods The clinical records of 30 patients who underwent laparoscopic right hemicolec- tomy through medial access（the laparoscopy group） and 27 patients who underwent conventional open laparoscopic right hemico- lectomy（the open group） were analyzed. The operative time, blood loss, numbers of lymph nodes harvested, time of passage of flatus, time of postoperative stay, and postoperative complications were compared. Results There were no significant differences in operative time, numbers of lymph nodes harvested and postoperative complications. Blood loss was significantly less in the lapa- roscopy group than in the open group [ （47. 1 ＋ 45. 8 ） ml vs （90. 3 ＋ 50. 7） ml ] （P 〈 0. 05 ）. The postoperative time of passage of flatus and postoperative stay in the laparoscopy group were respectively significantly shorter than those in the open group （P 〈 0. 05）. Conclusion Laparoscopic right hemicolectomy through medial access might be a safe and feasible procedure, with excel- lent minimally invasive effect and radical resection principle of malignant tumor.