尾侧中间联合入路与尾侧入路在腹腔镜右半结肠癌根治术中的应用对比

Comparison of caudal median combined approach and caudal approach in laparoscopic radical resection of right colon cancer

目的探讨尾侧中间联合入路与尾侧入路在腹腔镜右半结肠癌根治术中的应用效果。方法回顾性分析2017年2月至2022年2月实施腹腔镜右半结肠癌根治术的105例结肠癌患者病例资料,根据手术入路方式不同分为2组,尾侧组(行尾侧入路,n=52例),联合组(行尾侧中间联合入路,n=53例)采用SPSS 25.0统计学软件分析数据,手术指标、术后恢复指标等计量资料以(x±s)表示,行独立样本t检验;并发症等计数资料行χ^(2)检验。P<0.05为差异具有统计学意义。结果相较于尾侧组,联合组术中出血量更少,清扫淋巴结数量更多(P<0.05);两组手术时间、中转开腹率比较,差异无统计学意义(P>0.05)。与尾侧组相比,联合组患者术后恢复排气、排便及进食时间更短(P<0.05);两组患者术后拔除引流管及住院时间比较,差异无统计学意义(P>0.05)。术后30d内,两组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论尾侧中间联合入路与尾侧入路腹腔镜右半结肠癌根治术的安全性相当,但尾侧中间联合入路在减少术中出血量、清扫淋巴结和促进胃肠功能恢复方面更具优势。

Objective To investigate the effect of caudal middle combined approach and caudal approach in laparoscopic radical resection of right colon cancer.Methods Data of 105 patients with colon cancer who underwent laparoscopic radical resection of right half colon cancer from February 2017 to February 2022 were retrospectively analyzed.They were divided into two groups according to different surgical approaches.The caudal group(caudal approach,n=52 cases)and the combined group(caudal middle approach,n=53 cases)were analyzed using SPSS 25.0 statistical software.Measurement data such as surgical indicators and postoperative recovery indicators were represented by(x±s),and independent sample t test was performed.Complications were counted by chi-square test.P<0.05 was considered statistically significant.Results Compared with caudal group,the combined group had less blood loss and more lymph node dissection(P<0.05).There was no significant difference in operation time and conversion rate between the two groups(P>0.05).Compared with caudal group,the recovery time of exhaust,defecation and feeding was shorter in combined group(P<0.05).There was no significant difference in postoperative drainage tube removal and hospital stay between the two groups(P>0.05).Within 30 days after surgery,there was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion The safety of caudal median combined approach is comparable to that of caudal laparoscopic radical resection of right half colon cancer,but caudal median combined approach is more advantageous in reducing intraoperative blood loss,removing lymph nodes and promoting gastrointestinal function recovery.