完整结肠系膜切除术在腹腔镜右半结肠癌根治术中的应用

Application of complete mesocolic excision in laparoscopic radical surgery for right colon cancer

目的观察完整结肠系膜切除术在腹腔镜右半结肠癌根治术中的应用效果。方法选取我院2016年1月～2018年1月收治的结肠癌患者70例,分为两组,其中对照组32例行腹腔镜传统结肠癌根治术,腹腔镜组38例行完整结肠系膜切除术,应用统计学方法,对两组术后的各项手术观察指标及并发症情况进行比较分析。结果与对照组比较,腹腔镜组的术中出血量显著减少,肛门排气时间快、住院时间短,两组组间比较,差异存在显著性(P<0.05),但两组手术时间组间比较,未见明显差异。与对照组比较,腹腔镜组术中清扫淋巴结数量明显多于对照组,且阳性淋巴结数量也明显多于对照组,两组组间比较,差异存在显著性(P<0.05)。腹腔镜组术后无一例发生吻合口瘘,其并发症发生率为5.26%,显著少于对照组,两组术后并发症组间比较,差异存在显著性(P<0.05)。结论在腹腔镜右半结肠癌根治术中采取完整结肠系膜切除术有利于减少术中出血量、促进术后恢复、减少住院时间,且术后并发症少,值得广泛推广和应用。

Objective To observe the application effect of complete mesocolic excision in the laparoscopic radical surgery of right colon cancer.Methods 70 patients with colon cancer who were admitted to our hospital from January 2016 to January 2018 were selected and divided into two groups.Among them,32 patients in the control group were given conventional laparoscopic radical surgery of radical colon.38 patients were given complete mesocolic excision in the laparoscopy group.Statistical methods were used to compare and analyze the surgical observation indexes and complications of the two groups.Results Compared with the control group,the amount of intraoperative blood loss in the laparoscopy group was significantly reduced.The anal exhaust time was faster and the length of hospital stay was shorter.There were significant differences between the two groups(P<0.05).However,there was no significant difference between the two groups in the operation time.Compared with the control group,the number of dissected lymph nodes in the laparoscopy group was significantly higher than that in the control group.The number of positive lymph nodes was also significantly higher than that in the control group.There was significant difference between the two groups(P<0.05).No case of anastomotic leakage was detected in the laparoscopy group after surgery.The incidence rate of complications was 5.26%,which was significantly less than that in the control group.There were significant differences in postoperative complications between the two groups(P<0.05).Conclusion Complete mesocolic excision during laparoscopic radical surgery for right colon cancer is beneficial to reducing the amount of intraoperative blood loss,promoting postoperative recovery,reducing length of stay,and reducing fewer postoperative complications.It is worthy of widespread promotion and application.