经脐单孔腹腔镜右半结肠癌根治术临床疗效观察

Observation on the clinical effect of transumbilical single-incision laparoscopic radical resection of right colon cancer

目的观察经脐单孔腹腔镜右半结肠癌根治术的临床疗效。方法回顾性分析武汉大学人民医院胃肠外科2020年8月至2021年6月期间接受腹腔镜右半结肠癌根治术的74例患者的临床资料,其中经脐单孔腹腔镜右半结肠癌根治术30例(经脐单孔腹腔镜组),传统五孔腹腔镜右半结肠癌根治术44例(传统五孔腹腔镜组)。比较两组患者手术时间、术中出血量、术中清扫淋巴结数目、术后通气时间、术后住院时间、术后并发症和术后肿瘤复发率及术后生存质量等情况。结果两组术中出血量、术中清扫淋巴结数目、术后通气时间、术后住院时间、术后并发症和术后肿瘤复发率比较差异均无统计学意义(P>0.05)。经脐单孔腹腔镜组手术时间长于传统五孔腹腔镜组,术后疼痛评分低于传统五孔腹腔镜组,生存质量评分高于传统五孔腹腔镜组,差异有统计学意义(P<0.05)。结论经脐单孔腹腔镜右半结肠癌根治术与传统五孔法腹腔镜右半结肠癌根治术疗效相当,均安全、有效。其中单孔腹腔镜右半结肠癌根治术后疼痛更轻,生存质量更高,但手术时间更长。

Objective To observe the clinical effect of transumbilical single-incision laparoscopic radical resection of right colon cancer.Methods The clinical data of 74 patients who underwent laparoscopic radical resection of right colon cancer in Department of Gastrointestinal Surgery,Renmin Hospital of Wuhan University from August 2020 to June 2021 were retrospectively analyzed,including 30 cases who received transumbilical single-incision laparoscopic radical resection of right colon cancer(the transumbilical single-incision laparoscopic group)and 44 cases who received traditional five-hole laparoscopic radical resection of right colon cancer(the traditional five-hole laparoscopic group).The operative time,intraoperative blood loss,number of dissected lymph nodes during operation,postoperative ventilation time,postoperative hospital stay,postoperative complications,postoperative tumor recurrence rate and postoperative quality of life were compared between the two groups.Results There were no significant differences in the intraoperative blood loss,number of dissected lymph nodes during operation,postoperative ventilation time,postoperative hospital stay,postoperative complications and postoperative tumor recurrence rate between the two groups(P>0.05).The operative time in the transumbilical single-incision laparoscopic group was longer than that in the traditional five-hole laparoscopic group.The postoperative pain scores of the transumbilical single-incision laparoscopic group were lower than those of the traditional five-hole laparoscopic group.The scores of quality of life in the transumbilical single-incision laparoscopic group were higher than those in the traditional five-hole laparoscopic group,and the differences were significant(P<0.05).Conclusion Transumbilical single-incision laparoscopic radical resection of right colon cancer is as effective as traditional five-hole laparoscopic radical resection of right colon cancer.Both surgical methods are safe and effective.The patients receiving transumbilical single-incision laparoscopic radical resection of right colon cancer have less pain and higher quality of life,but their surgical procedures take a longer time.