单孔加一腹腔镜技术治疗右半结肠癌的中短期疗效分析:一项回顾性队列研究

Short-and medium-term outcomes of single-incision plus one port laparoscopic surgery in treatment of right colon cancer:a retrospective cohort study

目的:探讨单孔加一腹腔镜右半结肠癌根治术的中短期疗效。方法:回顾分析2017年1月至2022年11月收治的98例右半结肠癌患者的临床资料,根据手术方式分为单孔加一组(n=54)与常规组(五孔法施术,n=44),比较两组围手术期指标及随访情况。结果:两组均无中转开腹或增加辅助操作孔,无围手术期死亡病例。两组手术时间、出血量、肿瘤最大径、清扫淋巴结数量、首次排气排便时间、术后第1天与第3天白细胞计数、术后疼痛评分、术后住院时间及并发症差异均无统计学意义(P>0.05);单孔加一组总切口长度、首次下床活动时间短于常规组,差异有统计学意义(P<0.05)。两组3年无病生存率、3年总生存率差异无统计学意义(P>0.05)。结论:单孔加一腹腔镜技术治疗右半结肠癌是安全、可行的,且具有满意的中短期疗效。

Objective:To evaluate the short-and medium-term outcomes of single-incision plus one port laparoscopic radical resection for patients with right colon cancer.Methods:A retrospective analysis was conducted to collect data of 98 patients with right colon cancer from Jan.2017 to Nov.2022.According to the different surgical methods,the patients were divided into the single-incision plus one port group(n=54)and the conventional five-port surgery group(n=44).The perioperative indicators and follow-up conditions were compared between the two groups.Results:There was no conversion to laparotomy or adding an auxiliary operation port in both groups,and no perioperative death was found.There were no statistically significant differences between the two groups in operation time,blood loss,maximum diameter of tumor,total number of lymph nodes harvested,time to first flatus and defecation,white blood cell count on day 1 and day 3 after surgery,postoperative pain score,hospital stay and complications(P>0.05).While it showed shorter total length of incision and earlier ambulation in single-incision plus one port group,and the difference between the two groups was statistically significant(P<0.05).Additionally,there was no statistically significant difference in 3-year disease-free survival and 3-year overall survival between the two groups(P>0.05).Conclusions:It is safe and feasible to perform single-incision plus one port laparoscopic radical colectomy for right colon cancer patients,and it has satisfactory short-and medium-term outcomes.