腹腔镜辅助完整结肠系膜切除术与传统开腹术后并发症分析

Analysis of Postoperative Complications in the Laparoscopy-assisted Complete Mesocolic Excision and Traditional Operation

目的:探讨开腹完整结肠系膜切除术与腹腔镜辅助完整结肠系膜切除术两种术式的并发症风险及Clavien-Dindo分级。方法:回顾性分析136例结肠癌患者的临床资料,根据手术方式分为开腹组和腹腔镜组,每组68例患者,比较两组术后并发症的差异。结果:开腹组术后并发症发生率23.5%(16/68),腹腔镜组16.1%(11/68,P> 0.05);两组心血管、肺部及腹部并发症均无显著性差异(P> 0.05);Ⅰ、Ⅰ、Ⅲ期结肠癌患者术后并发症无显著性差异(P> 0.05);左半结肠癌与右半结肠癌术后并发症无显著性差异(P> 0.05)。术后并发症Clavien-Dindo分级,开腹组Ⅰ级2例,Ⅰ级10例,Ⅲa级0例,Ⅲb级1例,Ⅳa级1例,Ⅳb级0例,Ⅴ级0例;腹腔镜组Ⅰ级1例,Ⅰ级11例,Ⅲa级0例,Ⅲb级1例,Ⅳa级0例,Ⅳb级0例,Ⅴ级0例,均无显著性差异(P> 0.05)。结论:与开腹完整结肠系膜切除术相比,腹腔镜辅助完整结肠系膜切除术术后并发症风险未见明显差异,具有安全性。

Objective To investigate the risk of postoperative complications and Clavien-Dindo classification in the laparoscopy-assisted complete mesocolic excision and traditional operation.Methods Clinical data of 136 patients with colon cancer from Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province were analyzed.The patients were divided into laparoscopy group and traditional operation group according to the different modus operandi.Each group included 68 patients.The differences of the postoperative complications between the two groups were compared.Results There were no significant differences in the incidence of postoperative complications between the two groups.Data showed laparoscopyassisted complete mesocolic excision group16.1%(11/68)and traditional operation group23.5%(16/68)(P >0.05).Postoperative complications such as cardiovascular complications,pulmonary complications,abdominal complication,were no significant differences(P >0.05).There were no obvious differences in I、II、III stage colon cancer patients(P >0.05),the same results between the left-hemi colon cancer and the right-hemi colon cancer(P >0.05).Clavien-Dindo grading situation was distinguished as following:laparoscopy group included 1 case in grade I,11cases in grade II,zero in grade IIIa,1 case in grade IIIb,zero in grade IVa,IVb and V.Traditional operation group included 2 cases in grade I,10 cases in grade II,zero in grade IIIa,1 case in grade IIIb,1 case in grade IVa,zero in grade IVb and V.Conclusion Compared with trational operation,the laparoscopyassisted complete mesocolic excision showed feasible and safety,moreover,merely differences in the risk of postoperative complications.