基于三维重建引导下腹腔镜右半结肠切除术与传统手术的疗效及预后比较

Comparison on efficacy and prognosis of laparoscopic right hemicolectomy guided by 3D reconstruction and traditional surger

目的对比三维重建引导下腹腔镜右半结肠切除术与传统手术的疗效及预后。方法收集2016年1月至2017年5月行腹腔镜右半结肠切除术的73例患者临床资料,根据术前是否接受多层螺旋CT血管成像(MSCTA)三维重建分组,将单纯施行腹腔镜右半结肠切除术的36例患者纳入传统组,将术前接受MSCTA三维重建的37例患者纳入MSCTA组。采用SPSS23.0软件进行处理数据,手术相关指标以(x±s)表示,行独立样本t检验;并发症发生率、定位符合率、肿瘤复发率用百分比表示,用χ^(2)检验;生存率采用Log-Rank法检验。P<0.05为差异有统计学意义。结果MSCTA组手术时间、术中出血量少于传统组(P<0.05);两组患者淋巴结清扫数目、住院天数、并发症发生率、血管走形符合率、术后1年和3年生存率及肿瘤复发率相比,差异无统计学意义(P>0.05)。结论三维重建引导下腹腔镜右半结肠切除术有利于缩短手术时间,减少术中出血量,但对淋巴结清扫数目及并发症风险控制上无明显影响。

Objective To compare the eficacy and prognosis of laparoscopic right hemicolectomy guided by 3D reconstruction and traditional surgery.Methods The clinical data of 73 patients who underwent laparoscopic right hemicolectomy from January 2016 to May 2017 were collected.According to whether they received 3D reconstruction of muli-slice spiral CT angiography(MSCTA)before operation,36 patients who underwent laparoscopic right hemicolectomy alone were divided into traditional group.37 patients who underwent 3D reconstruction of MSCTA before operation were included in the MSCTA group.SPSS23 O software was used for processing.Surgery-related indicators were expressed by(x±s),and independent t test was used.The incidence of complications,localization coincidence rate and tumor recurrence rate were expressed as percentage with χ^(2) test.The survival rate was tested by Log-Rank method.P<0.05 was considered statistically significant.ResultsThe operation time and intraoperative bleeding in MSCTA group were less than those in traditional group(P<0.05).There was no significant diference in the number of lymph node dissection,length of hospital stay,incidence of complications,coincidence rate of vascular pattern,1-year and 3-year survival rate and tumor recurrence rate between the two groups(P>0.05).Conclusion3D reconstruction guided laparoscopic right colon resection can shorten the operation time and reduce intraoperative bleeding,but it has no significant effect on the number of lymph node dissection and the risk of complications.