腹腔镜切除术治疗右半结肠癌的临床观察

Clinical Observation of Laparoscopic Resection for Right Colon Cancer

目的对比不同入路腹腔镜右半结肠切除术治疗右半结肠癌的疗效。方法选取我院2015年9月至2018年2月收治的122例右半结肠癌患者为研究对象,按照随机数字表法分为两组,对照组行中央入路腹腔镜右半结肠切除术,治疗组行尾侧入路腹腔镜右半结肠切除术,对比两组手术情况、恢复情况、并发症情况及治疗前后生活质量评分、疼痛程度评分。结果与对照组[(77.25±36.98)mL]比较,治疗组[(60.61±24.02)mL]术中出血量更少(P<0.05);两组恢复情况对比差异无统计学意义(P>0.05)。治疗组、对照组并发症发生率分别为7.68%(4/52)、8.57%(6/70),治疗组、对照组2年生存率分别为76.92%(40/52)、72.86%(51/70),两组并发症和术后2年生存率相比较,差异无统计学意义(P>0.05)。治疗组治疗后躯体功能、物质生活、社会功能、心理功能评分均高于对照组[(21.34±1.28)分vs(18.34±1.26)分、(22.33±1.58)分vs(19.31±1.03)分、(22.34±1.28)分vs(19.12±1.01)分、(21.64±1.82)分vs(18.43±1.33)分],差异有统计学意义(P<0.05)。与对照组比较,治疗组治疗后12、24、48 h的VAS评分均更低[(2.99±0.12)分vs(3.25±0.22)分、(2.12±0.04)分vs(2.87±0.21)分、(1.21±0.03)分vs(1.87±0.11)分],差异有统计学意义(P<0.05)。结论尾侧入路腹腔镜右半结肠切除术治疗右半结肠癌,患者恢复情况与中央入路腹腔镜右半结肠切除术治疗相当,且失血量更少,可更有效地减轻患者疼痛感,提高患者生活质量。

Objective To compare the curative effect of laparoscopic right hemicolectomy via different approaches in the treatment of right hemicolon cancer.Methods A total of 122 patients with right hemicolon cancer admitted to our hospital from September 2015 to February 2018 were selected and randomly divided into control group and treatment group.The control group received laparoscopic right hemicolectomy via central approach,while the treatment group adopted laparoscopic right hemicolectomy via caudal approach.The operation,recovery,complications,scores of life quality before and after treatment,and scores of pain degree were compared between the two groups.Results Compared with the control group[(77.25±36.98)mL],the treatment group had less blood loss[(60.61±24.02)mL](P<0.05).There was no statistically significant difference in the recovery between the two groups(P>0.05).The incidence of complications in the treatment group and the control group were 7.68%(4/52)and 8.57%(6/70)respectively,the 2-year survival rates being 76.92%(40/52)and 72.86%(51/70)respectively,with no statistically significant difference in the complications and 2-year survival rate between the two groups(P>0.05).After treatment,the scores of physical function,material life,social function and psychological function in the treatment group were higher than those in the control group[(21.34±1.28)vs(18.34±1.26),(22.33±1.58)vs(19.31±1.03);(22.34±1.28)vs(19.12±1.01),(21.64±1.82)vs(18.43±1.33)],with statistically significant difference(P<0.05).After treatment,the VAS scores at 12,24 and 48 h in the treatment group were lower than those in the control group[(2.99±0.12)vs(3.25±0.22),(2.12±0.04)vs(2.87±0.21),(1.21±0.03)vs(1.87±0.11)],with statistically significant difference(P<0.05).Conclusion Laparoscopic right hemicolectomy via caudal approach in the treatment of right hemicolon cancer is as effective in terms of recovery as that via central approach,with less blood loss,which can effectively reduce the pain of patients and improve their life quality.