经脐切口行腹腔镜结直肠肿瘤切除术的并发症分析

The Analysis of the Complications in Transumbilical Laparoscopic Surgery for Colorectal Tumor Removal

目的评估腹腔镜下经脐切口移除组织标本的安全性情况。方法回顾性分析2012年1月至2015年12月期间,在我院接受腹腔镜结直肠手术并经脐切口取出标本的患者,记录手术部位感染(surgical site infection,SSI)和经脐切口疝的情况,并分析可能存在的危险因素。结果 13例患者出现SSI(6.50%),SSI组患者的体质指数、糖尿病比例及手术时间与无SSI组患者相比,差异具有统计学意义(P<0.05)。19例患者出现切口疝(9.50%),发生切口疝与没有发生切口疝组在性别、体重、体质指数、糖尿病、SSI和手术时间的差异具有统计学意义(P<0.05)。结论在现代腹腔镜手术中,选择经脐切口移除组织标本是一种安全、有效且美容的方法,避免术后SSI则是减少术后切口疝发生的关键因素。

Objective To evaluate the safety of transumbilical laparoscopic surgery for colorectal tumor removal Methods Retrospective analysis of was made of cases of laparoscopic colorectal surgery from January 2012 to December 2015 in our hospital as well as the umbilical incision specimen,the surgical site infection（ Surgical site infection,SSI） and the umbilical incision hernia were recorded,and the possible risk factors were analyzed. Results SSI occurred to 13 cases（ 6. 50%）. The body mass index（ BMI）,the proportion of diabetes and the time of operation in SSI group were statistically significant compared with those in the group without SSI（ P〈0. 05）. Incisional hernia happened in 19 cases（ 9. 50%）,and there were significant differences in sex,weight,body mass index,diabetes,SSI and operation time between those with incisional hernia and those without incisional hernia（ P〈0. 05）. Conclusion The transumbilical laparoscopic surgery proves to be a safe and effective method with better cosmetic effect. To avoid postoperative incisional hernia,it is important to prevent surgical site infection.