中间联合头侧入路腹腔镜直肠癌手术的效果及对253淋巴结清扫数目的影响

Effect of intermediate combined cephalic approach laparoscopic rectal cancer surgery and its influence on 253 lymph node dissection

目的探讨中间联合头侧入路腹腔镜直肠癌手术的临床疗效。方法选取郑州人民医院2018年7月至2019年10月行腹腔镜直肠癌手术治疗的90例直肠癌患者,采用抽签法分为观察组和对照组,每组45例。对照组采用传统中间入路,观察组采用中间联合头侧入路,比较两组术中出血量、术后住院时间、清扫253淋巴结时间、253淋巴结清扫数目、术后并发症发生率。结果两组术中出血量、术后住院时间比较差异未见统计学意义(P>0.05)。观察组手术时间长于对照组(P<0.05)。观察组253淋巴结清扫时间较对照组缩短,253淋巴结清扫数目较对照组多(P<0.05)。观察组术后并发症发生率(13.33%,6/45)略低于对照组(15.56%,7/45),但差异未见统计学意义(P>0.05)。结论相较于传统中间入路,中间联合头侧入路用于腹腔镜直肠癌手术可提高253淋巴结清扫数目,缩短253淋巴结清扫时间,降低术后并发症发生风险,具有较高的临床应用价值。

Objective To investigate the effect of intermediate combined cephalic approach laparoscopic rectal cancer surgery and its influence on 253 lymph node dissection in patients with rectal cancer.Methods From July 2018 to October 2019,90 patients with rectal cancer underwent laparoscopic surgery were selected and divided into observation group and control group by drawing lots,with 45 cases in each group.The control group used the traditional middle approach,and the observation group adopted the middle combined cephalic approach.The operation,intraoperative blood loss,postoperative hospital stay,time of 253 lymph node dissection,the number of 253 lymph node dissection and the incidence of postoperative complications were compared between the two groups.Results There was no significant difference in the intraoperative blood loss,postoperative hospital stay betwen the two groups(P>0.05).The operation time in observation group was longer than that in the control group(P<0.05).The 253 lymph node dissection time in observation group was shorter than that in the control group,and the 253 lymph node dissection number in observation group was more than that in the control group(P<0.05).The incidence of postoperative complications in the observation group(13.33%)was slightly lower than that in the control group(15.56%),but there was no significant difference(P>0.05).Conclusions Compared with the traditional middle approach,intermediate combined head side approach can increase the number of 253 lymph node dissection,shorten the time of 253 lymph node dissection,and reduce the risk of postoperative complications.