肠减压后腹腔镜下右半结肠切除术治疗梗阻性右半结肠癌的临床研究

Following Bowel Decompression Laparoscopic Right Hemicolectomy in the Treatment of Obstructive Right-sided Colonic Cancer:A Clinical Study

目的:探讨肠减压后腹腔镜下右半结肠切除术治疗梗阻性右半结肠癌的临床效果。方法:以2018年4月至2020年4月我科收治的54例梗阻性右半结肠癌患者为研究对象,患者不进行肠减压均无法建立腹腔镜操作空间,术后病理学检查证实为结肠癌。回顾患者资料,根据手术方式不同分为肠减压后腹腔镜下右半结肠切除术组(观察组,24例)和传统开腹结肠癌根治术组(对照组,30例),比较2组手术及围手术期指标。结果:观察组切口长度、术中出血量均小于对照组,术后肛门排气时间、住院时间均短于对照组,P<0.05。观察组手术时间略长于对照组,但差异无统计学学意义,P>0.05。观察组术后并发症发生率明显低于对照组,P<0.05。结论:肠减压后腹腔镜下右半结肠切除术治疗梗阻性右半结肠癌安全可行,可有效解决因梗阻肠段扩张严重导致腹腔镜操作时空间严重受限问题,而且创伤小,术后并发症少,患者恢复快。

Objective To investigate the clinical effect of laparoscopic right hemicolectomy(RHC)following bowel decompression in the treatment of obstructive right-sided colonic cancer(ORSCC).Methods The 54 ORSCC patients treated in author’s apartment from 2018-04to 2020-04were enrolled in this study:if they did not receive bowel decompression,impossible making operation gap for laparoscope,and they were confirmed as colonic cancer by using postoperative pathological exam.According to the procedures divided 24cases as observation group(following bowel decompression,implementing laparoscopic RHC),and 30cases as control group(routinely open radical procedure for colonic cancer);Then compared both groups’operative norms and the norms at perioperation.Results In incision length and intraoperative bleeding volume;in the time for postoperative flatus from anus,and for hospitalization;and in postoperative complication incidence,observation group was respectively smaller,shorter,and lower than control group(all,P<0.05);though in observation group the time for operation was slightly longer than in control group,but there was no statistical difference between the two groups(P>0.05).Conclusion Following bowel decompression laparoscopic RHC in the treatment of ORSCC is safe and feasible,can effectively solve the problem about laparoscope’s operation gap severely limited due to obstructed bowel segment expanded;And,it has such merits as smaller trauma,less postoperative complication,and fastly recovered.