腹腔镜与开腹全结肠系膜切除手术治疗右半结肠癌患者的效果比较

Comparison of effects of laparoscopic surgery and open complete mesocolic excision in treatment of patients with right colon cancer

目的:比较腹腔镜与开腹全结肠系膜切除手术治疗右半结肠癌患者的效果。方法:选取84例右半结肠癌患者为研究对象,按照随机数字表法分为对照组与观察组各42例。对照组采用开腹全结肠系膜切除手术治疗,观察组采用腹腔镜全结肠系膜切除手术治疗,比较两组手术相关指标水平、并发症发生率、局部复发率、远处转移率和死亡率。结果:观察组手术时间长于对照组,术中出血量少于对照组,术后首次排气时间、术后首次进食时间、引流管拔出时间和住院时间均短于对照组,差异有统计学意义(P<0.05);两组术中淋巴结清扫数量、术后2周并发症发生率、术后1年局部复发率、远处转移率和死亡率比较,差异均无统计学意义(P>0.05)。结论:腹腔镜与开腹全结肠系膜切除手术治疗右半结肠癌患者的效果相当,但腹腔镜全结肠系膜切除手术可缩短术后首次排气时间、术后首次进食时间、引流管拔出时间、住院时间,减少术中出血量。

Objective:To compare effects of laparoscopic surgery and open complete mesocolic excision in treatment of patients with right colon cancer.Methods:84 patients with right colon cancer were selected as the research objects,and were divided into control group and observation group according to the random number table method,42 cases in each group.The control group was treated by open complete mesocolic excision,while the observation group was treated by laparoscopic complete mesocolic excision.The levels of surgery-related indicators,complication rate,local recurrence rate,distant metastasis rate and mortality were compared between the two groups.Results:The operation time of the observation group was longer than that of the control group;the intraoperative blood loss was less than that of the control group;the first postoperative exhaust time,postoperative first eating time,drainage tube removal time and hospital stay were shorter than those of the control group;and the differences were statistically significant(P<0.05).There were no statistically significant differences in the number of lymph node dissections,the incidence of complications 2 weeks after the surgery,the local recurrence rate 1 year after the surgery,the distant metastasis rate and the mortality rate between the two groups(P>0.05).Conclusions:Laparoscopic surgery and open complete mesocolic excision have the same effects on the patients with right colon cancer.However,the laparoscopic complete mesocolic excision can shorten the first postoperative exhaust time,the first postoperative eating time,the drainage tube withdrawal time and the hospital stay,and reduce the intraoperative blood loss.