改良前方入路法腹腔镜结肠脾曲癌根治术的临床应用

Clinical Application of Modified Anterior Approach in Laparoscopic Radical Resection of Splenic Flexure Carcinoma of Colon

目的:探究改良前方入路法腹腔镜结肠脾曲癌根治术的临床应用。方法:选取2017年6月-2020年6月笔者所在医院收治的结肠脾曲癌患者90例,采用随机数字表法分为观察组和对照组,各45例,对照组采用传统入路法,观察组采用改良前方入路法,比较两组术中、术后情况。结果:两组中转开腹率比较差异无统计学意义(P>0.05),观察组手术时间短于对照组,术中出血量少于对照组,淋巴结清除数量多于对照组,差异均有统计学意义(P<0.05);观察组术后引流量少于对照组,排气时间早于对照组,住院时间短于对照组,差异均有统计学意义(P<0.05),两组下床活动时间比较差异无统计学意义(P>0.05);观察组并发症发生率(6.67%)低于对照组(24.44%),差异有统计学意义(P<0.05)。结论:改良前方入路法腹腔镜结肠脾曲癌根治术的临床应用效果良好。

Objective:To explore the clinical application of modified anterior approach in laparoscopic radical resection of splenic flexure carcinoma of colon.Method:A total of 90 patients with splenic curvature carcinoma of colon admitted to our hospital from June 2017 to June 2020 were selected and divided into the observation group and the control group by random number table method,with 45 patients in each group.The control group was treated with traditional approach,and the observation group was treated with modified anterior approach.The intraoperative and postoperative conditions of the two groups were compared.Result:There was no significant difference in the conversion rate between the two groups(P>0.05),the operative time in the observation group was shorter than that in the control group,the amount of intraoperative blood loss was less than that in the control group,and the number of lymph nodes removed was more than that in the control group,the differences were statistically significant(P<0.05).The postoperative drainage volume in the observation group was less than that in the control group,and the exhaust time and hospitalization time in the observation group were better than those in the control group,the differences were statistically significant(P<0.05),but there was no statistically significant difference in the activity time out of bed between the two groups(P>0.05).The incidence of complications in the observation group(6.67%)was significantly lower than that in the control group(24.44%),the difference was statistically significant(P<0.05).Conclusion:The clinical effect of modified anterior approach in laparoscopic radical resection of splenic flexure carcinoma of colon is good.