腹腔镜下右半结肠癌实施D3根治术的临床疗效

The clinical value of the D3 radical surgery under laparoscopy in the treatment of right colon cancer

目的：分析腹腔镜下实施右半结肠癌D3根治术的临床疗效。方法：选取2009年3月至2013年3月右半结肠癌入院手术患者90例,随机分为观察组和对照组各45例。对照组予以传统开腹手术,观察组予以腹腔镜下右半结肠癌D3根治术。对比2组患者一般手术情况、术后生活质量评分、术后1年及3年无瘤生存率和总生存率、术后并发症发生情况。结果：观察组的手术时间、术中出血量、恢复肠道排气时间和住院时间均显著短于对照组（P〈0.01）。观察组术后生理功能、心理情绪和社会功能评分均显著低于对照组（P〈0.01）。观察组3年的无瘤生存率、1年和3年总生存率均高于对照组（P〈0.05~P〈0.01）。观察组术后并发症发生率与对照组差异均无统计学意义（P〉0.05）。结论：腹腔镜下实施右半结肠癌D3根治术相比于传统开腹手术,具有创伤小、临床疗效佳、术后复发率低和安全性高的特点,值得临床应用。

Objective： To analyze the clinical efficacy of the D3 radical surgery under laparoscopy in the treatment of right colon cancer. Methods： Ninety patients with right colon cancer in our department from March 2009 to March 2013 were randomly divided into the observation group and control group. The observation group were treated with the D3 radical surgery under laparoscopy,and the control group were treated with the traditional open surgery. The general surgery condition,score of postoperative quality of life,postoperative 1,3-year disease-free survival and overall survival rates and postoperative complication in two groups were compared.Results： The operative time,blood loss,recovery time of hospital stay intestinal exhaust in observation group were significantly shorter than those in control group（ P〈0. 01）. The scores of the postoperative physiological function,psychological function,emotional function and social function in observation group were significantly lower than those in control group（ P〈0. 01）. The 3-year disease-free survival rate,and 1,3-year overall survival rate in observation group were significantly higher than those in control group（ P〈0. 05 to P〈0. 01）. The difference of the postoperative wound infection rate between two groups was not statistically significant（ P〉0. 05）.Conclusions： Compared with traditional open surgery,the D3 radical surgery under laparoscopy in the treatment of right colon cancer is fewer trauma,good effect,less postoperative recurrence rate and high security,which is worthy of clinical application.