快速康复外科理念联合腹腔镜技术在结直肠癌手术中的应用

Application of rapid rehabilitation surgery combined with laparoscopy in colorectal cancer surgery

目的探究快速康复外科理念联合腹腔镜技术在结直肠癌手术中的应用。方法选取本院2017年1月至2018年12月进行治疗的结直肠癌患者102例,观察A组21例采用快速康复外科理念联合腹腔镜技术治疗,观察B组34例采用快速康复外科理念联合传统开腹手术治疗,对照组47例采用单纯传统开腹手术治疗。对比3组术中、术后观察指标,以及术后并发症发生情况。结果相较于观察B组及对照组,观察A组的术中出血量显著减少,手术时间显著延长,切口显著减小,对比差异有统计学意义(P<0.05);相较于对照组,观察A组、观察B组的首次通气时间显著提前,住院时间显著缩短,对比差异有统计学意义(P<0.05),3组间淋巴结清扫个数对比差异无统计学意义;观察A组出现肺部感染、尿潴留、吻合口出血、吻合口瘘各1例,并发症总发生率为19.05%(4/21);观察B组发生吻合口瘘1例,发生切口感染及肠梗阻各2例,总并发症发生率为14.70%(5/34);对照组中吻合口瘘、肠梗阻各1例,切口感染发生3例,并发症总发生率为10.64%(5/47),3组对比差异无统计学意义。结论针对结直肠癌患者,采用快速康复外科理念联合腹腔镜技术治疗,可缩短住院时间,减少术后并发症,加快肠道功能的恢复,同时切口小、出血少,显著改善患者的生活质量,加快疾病康复速度,具有临床应用价值。

Objective To explore the application of rapid rehabilitation surgery combined with laparoscopy in colorectal cancer surgery. Methods 102 patients with colorectal cancer were treated in our hospital from January 2017 to December 2018. 21 patients in group A were treated with rapid rehabilitation surgery combined with laparoscopy, 34 patients in group B were treated with rapid rehabilitation surgery combined with traditional laparotomy, and 47 patients in control group were treated with simple traditional laparotomy. The intraoperative and postoperative observation indexes and postoperative complications were compared among the three groups. Results Compared with group B and control group, the amount of intraoperative bleeding in group A was significantly reduced, the operation time was significantly prolonged and the incision was significantly decreased (P<0.05). Compared with the control group, the first ventilation time was significantly earlier and the hospitalization time was significantly shorter in group A and B (P<0.05). There was no significant difference in the number of lymph node dissection among the three groups. Pulmonary infection, urinary retention, anastomotic bleeding and anastomotic leakage occurred in 1 case in groupA, the total inicidence of complication was 19.05%. 1 case of anastomotic leskage, 2 cases in incision infection and 2 cases in intestinal obstruction, and 5 cases (14.70%) in total com- plications of group B. There were 1 case of anastomotic leakage, 1 case of intestinal obstruction and 3 cases of incision infection in the control group, and the total incidence of complications was 5 cases (10.64%). There was no significant difference between the three groups. Conclusion For patients with colorectal cancer, rapid rehabilitation surgery combined with laparoscopy can shorten the hospitalization time, reduce postoperative complications, speed up the recovery of intestinal function, at the same time, the incision is small, the bleeding is less, the quality of life of the patients can be significantly improved, and the recovery speed of the disease can be accelerated.