3D腹腔镜下动脉优先入路治疗右半结肠癌的疗效及预后观察

Observation of short-term efficacy and prognosis of three-dimensional laparoscopic arterial preferential approach in the treatment of right semicolon carcinoma

目的探讨3D腹腔镜下动脉优先入路与传统侧方入路治疗右半结肠癌的短期疗效及预后效果。方法选择2015年1月至2016年1月亳州市人民医院收治的右半结肠癌78例,随机数字表法分组进行不同入路3D腹腔镜手术,各39例。对照组采取传统侧方入路,观察组采取动脉优先入路。对两组患者手术短期疗效及预后结果进行统计学分析。结果观察组患者的手术时间、术中出血量均较对照组减少,淋巴结清扫数量增加(t=5.763、27.316、6.485,均P<0.001)。与对照组比较,观察组术后腹腔引流量、术后排气时间、术后住院时间、术后第一次主动进食时间更短,短期疗效更优(t=18.656、6.928、6.153、6.462,均P<0.001)。对照组术后并发症发生率为15.4%(6/39),显著高于观察组的2.6%(1/39),差异有统计学意义(χ^2=3.923,P=0.048)。观察组2年生存率为82.1%,显著高于对照组的53.8%,差异有统计学意义(χ^2=6.689,P=0.001)。结论 3D腹腔镜下动脉优先入路相较于传统侧方入路治疗右半结肠癌短期疗效及预后均更优,安全性高,值得推广。

Objective To explore short-term efficacy and prognosis of three-dimensional laparoscopic arterial preferential approach and conventional lateral approach in the treatment of right semicolon carcinoma. Methods From January 2015 to January 2016, seventy-eight patients with right semicolon carcinoma were divided into two groups according to random number table method in Bozhou People’s Hospital. The control group received conventional lateral approach under three-dimensional laparoscopy while observation group received three-dimensional laparoscopic arterial preferential approach. The short-term curative effect and prognosis of the two groups were analyzed retrospectively. Results The operative time and intraoperative blood loss of patients in observation group were all reduced, and the number of lymph node dissection was increased compared with those in the control group(t=5.763, 27.316, 6.485, all P<0.001). Compared with the control group, the observation group had less postoperative drainage flow, postoperative exhaust time, postoperative hospitalization time, and the time of the first active feeding after the surgery, with better short-term efficacy(t=18.656, 6.928, 6.153, 6.462, all P<0.001). The incidence of postoperative complications in the control group was 15.4%(6/39), significantly higher than 2.6%(1/39) in the observation group. The difference was statistically significant(χ^2=3.923, P=0.048). The 2-year survival rate of the observation group was 82.1%, which was higher than 53.8% of the control group. The difference was statistically significant(χ^2=6.689, P=0.001). Conclusion The short-term efficacy and prognosis of three-dimensional laparoscopic arterial preferential approach is better than traditional lateral approach for the treatment of right semicolon carcinoma, and has high safety and worthy of promotion.