经肛肠减压后3D腹腔镜根治术治疗梗阻性结肠癌的临床观察

Clinical effect of 3D laparoscopic radical operation in treatment of obstructive colon cancer after anorectal decompression

目的探讨经肛肠减压后3D腹腔镜根治术治疗梗阻性结肠癌的临床疗效。方法回顾性分析2015年6月至2018年6月收治的54例梗阻性结肠癌患者的临床资料,所有患者术前均经肛肠减压,根据手术方式分为3D组(25例)和开腹组(29例),所有数据均应用SPSS22.0软件进行统计学分析,围术期相关指标等计量资料以(x^-±s)表示,采用独立样本t检验;术后并发症发生率组间比较采用χ^2检验,P<0.05为差异有统计学意义。结果两组患者术前减压管放置时间、手术时间和淋巴结清扫数目比较,差异均无统计学意义(P>0.05);3D组术中出血量、首次通气时间以及平均住院时间均明显少于开腹组,但平均住院费用高于开腹组;两组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论经肛肠减压后实施3D腹腔镜根治术治疗梗阻性结肠癌是安全、有效的,术中出血量少、术后恢复快,值得在临床广泛推广应用。

Objective To investigate the clinical efficacy of 3 D laparoscopic radical operation in treatment of obstructive colon cancer after anorectal decompression. Methods The clinical data of 54 patients with obstructive colon cancer admitted into our hospital from June 2015 to June 2018 were analyzed retrospectively. All cases were received anorectal decompression before surgery, according to surgical procedures, the patients were divided into 3 D group(25 patients) and laparotomy group(29 patients). Statistical analysis was performed by using SPSS 22.0 software, perioperative indicators were expressed as (x^-±s) and examined by using t test. The post-operative complication rate was examined by chi square test. A P value of <0.05 was considered as significant difference. Results There were no significant difference in decompression tube indwelling time, operation time and number of dissected lymph nodes between the two groups(P>0.05). The intraoperative blood loss, first flatus time and average hospitalization time in 3 D group were significantly less than those in laparotomy group, the hospitalization cost in 3 D group was significantly higher than that in laparotomy group(P<0.05);No significant difference was observed in postoperative complication rate between the two groups(P>0.05). Conclusion 3 D laparoscopic radical operation in the treatment of obstructive colon cancer after anorectal decompression is feasible and safe, with less intraoperative bleeding and faster postoperative recovery, which is valuale to be applied in clinical.