腹腔镜右半结肠癌D3根治术的临床分析

Clinical analysis of laparoscope right hemicolon carcinoma D3 radical excision

目的对比腹腔镜右半结肠癌D3根治术与传统开腹右半结肠癌D3根治术的手术安全性和近期临床疗效。方法回顾分析我院2012年3月~2014年10月,63例行腹腔镜辅助右半结肠癌D3根治术患者(观察组)与同期56例行传统开腹右半结肠癌D3根治术患者(对照组),比较两组手术情况、术后功能恢复情况、术后并发症、术后局部复发和转移情况。结果观察组术中出血量、肠道功能恢复时间和总住院时间明显少于对照组(P<0.01);观察组术后并发症发生率明显低于对照组(P<0.01);局部复发率、远处转移率与对照组比较差异无统计学意义(P>0.05)。结论相对于开腹右半结肠癌根治术而言,腹腔镜辅助右半结肠癌根治术比传统手术出血少、肠道功能恢复快、并发症率低和住院时间短等优势,近期疗效与传统手术相当。

Objectives To compare surgical safety and clinical effects in short term of laparoscopic and traditional open radical resection of right colon cancer D3 surgery. Methods 63 cases of laparoscope right hemicolon carcinoma D3 radical excision as observation group and 56 cases of traditional open abdomen right hemicolon carcinoma D3 radical excision as control group in our hospital from March 2012 to October 2014 were retrospective analyzed. Operation conditions, functional restorations after operation, postoperative complications, and local recurrences and metastasis after operation of both groups were compared. Results Bleeding volume during operation, intestinal exhaust time and stay length of observation group were obviously less than those of control group （P〈~0.01）. The incidence rate of postoperative complications in observation group was obviously lower than that in control group（P^0.01）. While there were no significant differences of local recurrence rates and distant metastasis rates in both groups （P^0. 05）. Conclusions Compared with traditional open abdomen right hemicolon carcinoma radical excision, laparoscope assisting right hemicolon carcinoma radical excision has advantages such as less bleeding volume during operation, quicker intestinal functional restoration,lower complications rate and shorter stay length. Its short term effects were correspondent to traditional open abdomen operation.