头侧-尾侧-中间入路行腹腔镜右半结肠癌根治术的临床3年随访研究

A three-year follow-up study of laparoscopic radical right hemicolectomy through cephalic-caudal-middle approach

目的探讨头侧-尾侧-中间入路行腹腔镜右半结肠癌根治术的临床3年随访研究。方法回顾性分析2015年1月至2017年4月收治的83例右半结肠癌患者资料,均接受腹腔镜右半结肠癌根治术治疗。根据术中入路方式不同分为两组,将中间入路的40例患者纳入中间入路组,将以头侧-尾侧-中间入路的43例患者纳入混合入路组。采用SPSS 24.0软件进行数据处理,手术相关指标、术后恢复情况等计量资料以(x±s)表示,采用独立t检验;并发症、复发率及转移率等计数资料采用χ^(2)检验,P<0.05为差异有统计学意义。结果混合入路组手术时间、术中出血量均比中间入路组少(P<0.05);两组肛门排气时间、初次饮食时间、腹腔引流时间、住院时间、术中淋巴结清扫数量、术后3年复发率及转移率相比,差异均无统计学意义(P>0.05)。混合入路组并发症总发生率比中间入路组低(7.0%vs.22.5%)。结论与中间入路相比,头侧-尾侧-中间入路行腹腔镜右半结肠癌根治术可有效缩短手术时间,减少术中出血量,进而降低术后并发症风险。

Objective To investigate the 3-year clinical outcome of laparoscopic radical right hemicolectomy for colon cancer through cephalic-caudal-middle approach.Methods From January 2015 to April 2017,clinical data of 83 patients with right hemicolon cancer who received laparoscopic radical right hemicolectomy were analyzed retrospectively.According to the intraoperative approach,40 cases who received tractional intermediate approach were divided into the intermediate approach group,and 43 cases who received cephalic-caudal-middle approach were divided into the mixed approach group.Statistical software SPSS20.0 were used for data analysis.Measurement data such as surgical indicators and postoperative recovery were expressed as (x±s),and were examined by using independent t test.Count data such as complications,recurrence rate,and metastasis rate were expressed as percentages,and chi-square test was used,A P value of<0.05 was considered as statistically significant difference.Results The operation time and intraoperative blood loss in the mixed approach group were lower than those in the intermediate approach group respectively(P<0.05).There were no significant difference betweenχ^(2) groups in terms of anal exhaust time,initial diet time,abdominal drainage time,length of hospital stay,number of lymph node dissections,recurrence rate and metastasis rate at 3 years after operation(P>0.05).The total incidence of complications in the mixed approach group was much lower than in the intermediate approach group(7.0%vs.22.5%),with significant difference(P<0.05).Conclusion Compared with the intermediate approach,the cephalic-caudal-middle approach could effectively shorten the operation time,reduce intraoperative blood loss and reduce the risk of postoperative complications.