腹腔镜下保留自主神经右半结肠癌D3根治术的可行性及应用价值分析

Analysis of the feasibility and application value of laparoscopic D3 radical resection preserving autonomic nerve for right colon cancer

目的探讨腹腔镜下保留自主神经右半结肠癌D 3根治术的可行性及应用价值。方法回顾性分析60例右半结肠癌患者的临床资料。所有患者均接受腹腔镜下右半结肠癌D 3根治术。根据是否切除肠系膜上神经丛,分为切除组(n=32)和保留组(n=28)。比较两组患者的手术指标和并发症发生情况。结果保留组手术时间短于切除组(P<0.05),乳糜漏和腹泻发生率低于切除组(P<0.05)。两组术中出血量、淋巴结清扫数量、术后肛门排气时间和住院时间差异无统计学意义(P>0.05)。结论腹腔镜下保留自主神经右半结肠癌D 3根治术可行,且可避免因神经损伤而引发的术后胃肠功能紊乱及乳糜漏。

Objective To investigate the feasibility and application value of laparoscopic D 3 radical resection preserving autonomic nerve for right colon cancer.Methods The clinical data of 60 patients with right colon cancer were analyzed retrospectively.All patients received laparoscopic D 3 radical resection for right colon cancer.According to whether or not the superior mesenteric plexus was resected,patients were divided into resection group(n=32)or preservation group(n=28).Surgical indicators and the incidence of complications were compared between the two groups.Results The operation duration of the preservation group was shorter than that of the resection group(P<0.05).The incidence of chylous leakage and diarrhea was lower in the preservation group than in the resection group(P<0.05).There was no statistically significant difference in intraoperative blood loss,the number of lymphadenectomy,postoperative anal exhaust time,or hospital stays between the two groups(P>0.05).Conclusion Laparoscopic D 3 radical resection preserving autonomic nerve for right colon cancer is feasible,for it can avoid postoperative gastrointestinal disorder and chylous leakage caused by nerve injury.