腹腔镜尾侧入路右半结肠癌根治术的临床应用研究

Clinical value of right hemicolectomy using laparoscopic caudal approach

目的探讨腹腔镜尾侧入路和中央入路下右半结肠癌根治术的临床疗效。方法选取2017年4月至2019年4月间宝鸡市扶风县中医医院收治的90例右半结肠癌患者,采用随机数表法分为尾侧组和中央组,每组45例。尾侧组患者采用腹腔镜尾侧入路右半结肠癌根治术,中央组患者采用腹腔镜中央入路下右半结肠癌根治术,比较两组患者手术及术后各项指标。结果尾侧组患者手术时间和术中出血量均较中央组少,差异均有统计学意义(均P<0.05);两组患者清除阳性淋巴结、排气恢复时间及排便恢复时间比较,差异无统计学意义(P>0.05)。两组患者术后均出现2例并发症患者,差异无统计学意义(P>0.05)。结论腹腔镜尾侧入路在右半结肠癌根治术中,与中央入路方式临床清除淋巴结无差异,在手术时间和出血量方面存在一定优势。

Objective To explore the clinical efficacy of laparoscopic caudal approach and central approach for right hemicolectomy.Methods From April 2017 to April 2019,90 patients with right hemicolon cancer were retrospectively included in the study.Using digital random method,they were divided into a caudal group and a central group with 45 patients in each group.In the caudal group,laparoscopic right hemicolectomy was performed using caudal approach and laparoscopic right hemicolectomy was performed using central approach in central group.The operative and postoperative indexes were compared between the two groups.Results The operation time and bleeding volume was lower in caudal group than in central group(all P<0.05).There was no significant difference in the number of positive lymph nodes removed,and time to recovery of exhaust and defecation between the two groups(P>0.05).Complicaitons occurred in 2 patients in both groups(P>0.05).Conclusion There was no significant difference in the number of positive lymph nodes removed between right hemicolectomy using laparoscopic caudal approach and central approach.However,laparoscopic caudal approach has some advantages in operation time and bleeding volume.