腹腔镜下中间入路与侧方入路右半结肠癌根治术的术中、术后情况比较

Comparison of intraoperative and postoperative condition of laparoscopyradical resection of the right hemi-colon carcinoma by medial approach and lateral approach

目的:探讨腹腔镜下中间入路右半结肠癌根治术的临床疗效及并发症。方法:回顾性分析在2015年6月1日至2018年6月1日期间由中国人民解放军第967医院普外科收治的82例右半结肠癌患者临床资料,45例患者接受腹腔镜中间入路右半结肠癌根治术,为中间入路组,37例患者接受腹腔镜侧方入路右半结肠癌根治术,为侧方入路组;对比两组患者手术时间、术中出血量、清扫淋巴结数量、中转开腹率、术后肠功能恢复时间、术后住院时间及术后并发症等临床指标,评价分析腹腔镜下中间入路右半结肠癌根治术的优越性。结果:中间入路组手术时间、术中出血量、淋巴结清扫数量、中转开腹率与侧方入路组相比差异显著,均有统计学意义(P<0.05);但中间入路组在术后肠功能恢复时间、术后住院时间及术后并发症发生情况等方面与侧方入路组相比无统计学差异(P>0.05)。结论:采用腹腔镜下中间入路右半结肠癌根治术能缩短手术时间、减少术中出血量、减少中转开腹率、增加清扫淋巴结个数,近期治疗效果满意,值得在临床中应用并推广。

Objective:To study the clinical efficacy and postoperative complications of laparoscopy radical resection of the right hemi-colon carcinoma by medial approach.Methods:Clinical data of 82 patients with right hemi-colon carcinoma admitted to the department of general surgery of the 967th Hospital of Chinese People's Liberation Army from June 1,2015 to June 1,2018,who were given laparoscopy radical resection of the right hemi-colon carcinoma were retrospectively analysed.They were assigned to groups according to different surgical approaches.45 patients who were given medial approach were assigned to the medial approach group,and 37 patients who were given lateral approach were assigned to the lateral approach group.The operation time,volume of bleeding during surgery,number of lymph node dissection,conversion to laparotomy rate,postoperative intestinal function recovery time,postoperative length of hospital stay and postoperative complications were compared between two groups.The superiority of laparoscopy radical resection of the right hemi-colon carcinoma by medial approach was evaluated and analysed.Results:There was statistically significant difference in the operation time,volume of bleeding during surgery,number of lymph node dissection and conversion to laparotomy rate between the medial approach group and the lateral approach group(P<0.05).But there was no statistically significant difference in the postoperative intestinal function recovery time,postoperative length of hospital stay and postoperative complications between the medial approach group and the lateral approach group(P>0.05).Conclusion:Laparoscopy radical resection of the right hemi-colon carcinoma by medial approach can shorten the operation time,reduce the volume of bleeding during surgery,reduce the conversion to laparotomy rate,increase the number of lymph node dissection.The short-term efficacy is satisfactory,which is worthy of clinical application.