腹腔镜左半结肠癌根治术“头侧-中央联合入路方式”的临床疗效评价

Evaluation of clinical effect of "head-central combined way" in laparoscopic radical operation of left colon cancer

目的探讨腹腔镜左半结肠癌根治术“头侧-中央联合入路方式”的可行性及临床疗效。方法回顾性分析2017年1月至2018年6月广州市红十字会医院普外科收治的40例左半结肠癌病人行腹腔镜手术的临床资料,其中20例采用“头侧-中央联合入路方式”(HCCW组),另20例采用“传统中央入路方式”(TCW组)。对比分析两组病人的临床病理特征、手术时间、术中出血量、淋巴结清扫数量及术后并发症等。结果HCCW组和TCW组病人清扫的淋巴结数目分别为(17.95±5.15)个和(15.05±3.69)个,差异有统计学意义(P<0.05);HCCW组手术时间、术中出血量显著少于TCW组(P<0.05);HCCW组和TCW组病人术后并发症发生率(30%比35%)差异无统计学意义(P>0.05)。结论腹腔镜左半结肠癌根治术“头侧-中央联合入路方式”治疗左半结肠癌,安全可行,且手术方式更容易进入解剖层面,减少手术时间及创伤。

Objective To investigate the feasibility and clinical efficacy of combined cranial-central approach in laparoscopic radical resection of left colon cancer.Methods The clinical data of 40 patients with left colon cancer who underwent laparoscopic surgery from January 2017 to June 2018 were retrospectively analyzed.Twenty patients were treated with"combined cranial-central approach"(HCCW group)and the other 20 patients were treated with"traditional central approach"(TCW group).The clinicopathological characteristics,operative time,intraoperative blood loss,number of lymph node dissection and postoperative complications of the two groups were compared and analyzed.Results The average number of dissected lymph nodes in HCCW group and TCW group was(17.95±5.15)and(15.05±3.69),respectively.There was significant difference in the number of dissected lymph nodes between the two groups(P<0.05).As compared to TCW group,the operation time and intraoperative blood loss were less in the HCCW group(P<0.05);There was no significant difference in postoperative complication rate or mortality between HCCW group and TCW group(P>0.05).Conclusion Laparoscopic left hemicolectomy combined with cranial-central approach is safe and feasible for the treatment of left colon cancer.The surgical approach is easier to enter the anatomical level and reduce the operation time and trauma.