腹腔镜下不同入路右半结肠癌根治术的疗效比较

Comparison of different approaches of laparoscopic radical resection for right colon cancer

目的比较腹腔镜下2种不同入路右半结肠癌根治术的优缺点。方法回顾性分析2015年3月至2016年12月我院收治41例结肠癌患者的临床资料,根据腹腔镜下不同的手术入路行右半结肠癌根治术,将其分为尾侧背侧入路组(23例)和经典中间入路组(18例)。比较2组在手术时间、术中出血量、中转开腹率、淋巴结清扫个数、住院时间和术后并发症方面的差别。结果尾侧背侧入路组在手术时间、术中出血量、中转开腹率上优于经典中间入路组,差异有统计学意义(P<0.05)。2组患者的住院时间、淋巴结清扫个数、术后并发症比较,差异无统计学意义(P>0.05)。结论腹腔镜下右半结肠癌根治术采用尾侧背侧入路操作简单,层次清晰,能缩短手术时间,减少出血量。

Objective To compare the advantages and disadvantages of two approaches of laparoscopic radical resection for right colon cancer. Methods The data of 41 patients with right colon cancer in our hospital from March 2015 to December 2016 were analyzed retro- spectively,who were randomly divided into the caudal-to-cranial group（ n = 23 ） and classical medial-to-lateral group（ n = 18 ） according to different approaches. The operation time, intraoperative blood loss, conversion rate, the number of lymph nodes dissection, hospital stay time and postoperative complications between two groups were compared. Results The operation time, intraoperative blood loss, the conversion rate of the caudal-to-cranial group were better than those of the classical medial-to-lateral group, the differences were significant （ P 〈 0.05 ）. There was no significant difference in hospital stay time, the number of lymph nodes dissection and postoperative complications between two groups. Conclusion Laparoscopic radical resection for right colon cancer by caudal-to-cranial approach is easy to operate and dissect,it can shorten the operation time, decrease the intraoperative blood loss, which is worthy of clinical promotion.