电钩法腹腔镜结直肠肿瘤手术的应用体会

The experiences of electrocoagulation hook method in laparoscopic operation for colorectal tumor

目的:对比开放手术与电钩法腹腔镜结直肠肿瘤手术的治疗效果,探讨更合理的手术方案。方法:随机将60例活检病理确诊的结直肠癌患者平均分为两组,研究组行电凝钩法腹腔镜手术,对照组行常规开腹手术。对比分析两组手术时间、术中出血量及围手术期并发症等指标。结果:研究组均成功完成电钩法腹腔镜手术,无一例中转开腹。研究组术中失血量、术后腹腔引流量、术后肠道功能恢复时间、术后切口疼痛、住院时间、住院费用均优于对照组(P<0.05);两组手术时间、术中淋巴结清扫情况、吻合口漏、尿潴留、腹腔感染、切口感染差异无统计学意义(P>0.05)。结论:电钩法腹腔镜结直肠肿瘤手术是安全、可行的,微创效果好,不但可节约医疗资源,同时明显降低了手术费用,在经济条件困难的患者或无超声刀的医院,尤其基层医院值得开展推广。

Objective：To compare the therapeutic effect of laparoscopic resection of colorectal tumors with electrocoagulation hook and open surgery,in order to develop a more reasonable operation scheme. Methods：Sixty patients who were diagnosed as colorectal cancer by pathological biopsy were randomly divided into clinical research group and the control group. Patients in clinical research group underwent laparoscopic operation with electrocoagulation hook while patients in control group underwent conventional open operation. A comparative study was made between the two groups in terms of operation time,intraoperative blood loss and perioperative complications. Results：All operations in research group were successful,no cases were converted to laparotomy. The intraoperative blood loss,the amount of postoperative drainage,postoperative intestinal function recovery time,postoperative incisional pain,the hospital stay and cost were better in the research group than those in the control group（P〈0. 05）. There were no significant differences in operative time,the number of lymph nodes harvested,anastomotic leakage,uroschesis,abdominal infection or incisional infection between two groups（P〉0. 05）. Conclusions：Laparoscopic operation for colorectal tumors with electrocoagulation hook method is safe,feasible and mini-invasive,which can not only save medical resources but also significantly reduce surgery cost,so it is worthy to be popularized in patients with difficult economic conditions,and hospitals without ultrasonic knife,especially in the primary hospitals.