全腹腔镜改良吻合方案应用于左半结肠癌根治术中的临床疗效及安全性

Influence of modified anastomosis with total laparoscopy on clinical efficacy and safety of patients undergoing left hemicolectomy

目的:探讨全腹腔镜改良吻合方案对左半结肠癌根治术临床疗效及安全性的影响,为后续临床吻合方案提供更多参考。方法:回顾分析2015年1月至2018年8月收治的87例左半结肠癌根治术患者的临床资料,其中47例行腹腔镜辅助常规吻合(对照组),40例行全腹腔镜改良吻合(观察组)。对比分析两组总手术时间、吻合时间、切口长度、术中出血量、淋巴结清扫数量、术后首次排气时间、术后住院时间及术后并发症发生情况。结果:观察组总手术时间、切口长度及术中出血量优于对照组(P<0.05);观察组吻合时间多于对照组(P<0.05);两组术后淋巴结清扫数量、术后首次排气时间及术后住院时间、术后并发症发生率差异无统计学意义(P>0.05)。结论:与腹腔镜辅助常规吻合方案相比,全腹腔镜改良吻合方案用于左半结肠癌根治术有助于缩短手术时间、减小腹部切口、减少术中出血量,具有临床应用价值。

Objective:To investigate the influence of modified anastomosis with total laparoscopy on clinical efficacy and safety of patients undergoing left hemicolectomy,and to provide more references for anastomotic schemes selection in clinical practice with follow-up.Methods:Clinical data of 87 patients undergoing left hemicolectomy were retrospectively analyzed in the period from Jan.2016 to Aug.2018,and patients were divided into 2 groups including control group(47 patients)with laparoscopic-assisted routine anastomosis and observation group(40 patients)with modified anastomosis and total laparoscopy.The total operation time,anastomotic operation time,incision length,intraoperative bleeding volume,number of lymph node dissection,exhaust time for first time,hospital stay and complications incidence after operation of 2 groups were compared.Results:The total operation time,incision length,intraoperative bleeding volume of observation group was significantly less than control group(P<0.05).The anastomotic operation time of observation group was significantly more than control group(P<0.05).There was no significant difference in the number of lymph node dissection,exhaust time for the first time and hospital stay between 2 groups(P>0.05).There was no significant difference in the complications incidence after operation between 2 groups(P>0.05).Conclusions:Compared with laparoscopic-assisted routine anastomosis,modified anastomosis with total laparoscopy in the treatment of patients undergoing left hemicolectomy can efficiently decrease the operation time,shorten the length of abdominal incision,reduce the intraoperative bleeding volume and possess more clinical application value.