BACKGROUND Changes in bowel function after right-sided colectomy are not well understood compared to those associated with left-sided colectomy or rectal resection.In particular,there are concerns about bowel function...BACKGROUND Changes in bowel function after right-sided colectomy are not well understood compared to those associated with left-sided colectomy or rectal resection.In particular,there are concerns about bowel function after right-sided colectomy with complete mesocolic excision,which has become popular in the West.AIM To evaluate the functional outcomes of patients who underwent right-sided colectomy with D3 lymphadenectomy for colon cancer.METHODS Functional data from patients who underwent minimally invasive right-sided colectomy for colon cancer from October 2017 to September 2018 were prospectively collected.Functional outcomes were evaluated preoperatively and at 3,6,12,and 18 mo postoperatively.RESULTS Prior to surgery,57 patients answered the questionnaire,and 47 responded at three months,52 at 6 mo,52 at 12 mo,and 25 at 18 mo postoperatively.Most scales of quality of life and bowel function improved significantly over time.Urgency persisted to a high degree throughout the period without a significant change over time.The use of medications for defecation was about 10%over the entire period.Gas(P=0.023)and fecal frequency(P<0.001)increased,and bowel dysfunction group(P=0.028)was more common among patients taking medication.At six months,resected bowel and colon lengths were significantly different as a risk factor between the dysfunction group and the no dysfunction group[odd ratio(OR):1.095,P=0.026;OR:1.147,P=0.031,respectively]in univariate analysis,but not in multivariate analysis.CONCLUSION Despite D3 lymphadenectomy,most bowel symptoms improved over time after right-sided colectomy using a minimally invasive approach,and continuous medication was needed in only approximately 10%of patients.展开更多
目的:探讨高龄右半结肠癌患者行腹腔镜全结肠系膜切除术的安全性、可行性。方法:回顾分析2006年1月至2017年1月收治的189例70岁以上右半结肠癌患者的临床资料,其中108例接受腹腔镜全结肠系膜切除术(研究组),81例接受腹腔镜传统结肠癌根...目的:探讨高龄右半结肠癌患者行腹腔镜全结肠系膜切除术的安全性、可行性。方法:回顾分析2006年1月至2017年1月收治的189例70岁以上右半结肠癌患者的临床资料,其中108例接受腹腔镜全结肠系膜切除术(研究组),81例接受腹腔镜传统结肠癌根治术(对照组),比较两组患者术前情况、手术相关指标及术后恢复指标。结果:两组患者术前一般情况差异均无统计学意义(P>0.05),两组均无手术相关死亡病例。研究组、对照组中转开腹率(4.6%vs. 4.9%)、手术时间[(174.3±47.4) min vs.(167.2±57.9) min]、术中出血量[(89.9±72.8) mL vs.(98.8±67.6) mL]、排气时间[(2.7±1.1) d vs.(3.0±1.3) d]、进食流质时间[(2.8±1.5) d vs.(3.2±1.9) d]、住院时间[(10.4±4.5) d vs.(11.2±5.5) d]、术后并发症发生率(21.3%vs.23.5%)差异均无统计学意义(P>0.05)。研究组淋巴结获取数量[(15.6±4.8) vs.(12.8±4.5)]多于对照组(P<0.01)。结论:腹腔镜全结肠系膜切除术治疗高龄右半结肠癌是安全、可行的,可取得更好的肿瘤学近期疗效。展开更多
目的探讨腹腔镜辅助根治性右半结肠切除术的临床应用效果。方法回顾性分析揭阳市人民医院普通外科一区2013年8月至2017年8月收治的95例右半结肠癌根治术患者的临床资料,根据手术方式不同将患者分为腹腔镜组47例和开腹组48例。腹腔镜组...目的探讨腹腔镜辅助根治性右半结肠切除术的临床应用效果。方法回顾性分析揭阳市人民医院普通外科一区2013年8月至2017年8月收治的95例右半结肠癌根治术患者的临床资料,根据手术方式不同将患者分为腹腔镜组47例和开腹组48例。腹腔镜组采用腹腔镜辅助根治性右半结肠切除术,开腹组采用常规开腹手术,比较两组患者的手术情况(手术时间、切口长度、术中出血量)、术中淋巴结清扫情况(肠系膜根部淋巴结清扫数、阳性淋巴结检出率)、术后肠道功能恢复情况(术后肛门首次排气排便时间、腹胀腹痛持续时间、住院时间),以及术后并发症的发生和肿瘤复发转移情况。结果腹腔镜组与开腹组患者的手术时间[(156.51±16.62) min vs (126.62±15.51) min]、术中出血量[(85.52±15.73) mL vs (100.85±18.95) mL]和切口长度[(5.23±0.65) cm vs (18.52±3.68) cm]比较,腹腔镜组手术时间长于开腹组,术中出血量少于对照组,切口长度小于对照组,差异均有统计学意义(P<0.05);腹腔镜组与开腹组患者的淋巴结清扫数目[(5.01±1.60)个 vs (5.22±1.57)个]和阳性淋巴结比例(8.51% vs 10.42%)比较,差异均无统计学意义(P>0.05);腹腔镜组与开腹组患者的首次排气时间[(2.21±1.28) d vs (3.82±1.51) d]、首次排便时间[(2.51±1.76) d vs (4.58±1.82) d]、腹痛腹胀持续时间[(2.01±0.82) d vs (3.59±1.57) d]、住院时间[(7.15±2.08) d vs(15.35±3.65) d]比较,腹腔镜组均明显短于开腹组,差异均有统计学意义(P<0.05);腹腔镜组与开腹组患者术后肿瘤复发率分别为2.13%和 2.08%、转移率分别为4.26%和6.25%,差异均无统计学意义(P>0.05)。结论腹腔镜辅助根治性右半结肠切除术具有和开腹手术同样的临床疗效,且微创、利于术后恢复。展开更多
文摘BACKGROUND Changes in bowel function after right-sided colectomy are not well understood compared to those associated with left-sided colectomy or rectal resection.In particular,there are concerns about bowel function after right-sided colectomy with complete mesocolic excision,which has become popular in the West.AIM To evaluate the functional outcomes of patients who underwent right-sided colectomy with D3 lymphadenectomy for colon cancer.METHODS Functional data from patients who underwent minimally invasive right-sided colectomy for colon cancer from October 2017 to September 2018 were prospectively collected.Functional outcomes were evaluated preoperatively and at 3,6,12,and 18 mo postoperatively.RESULTS Prior to surgery,57 patients answered the questionnaire,and 47 responded at three months,52 at 6 mo,52 at 12 mo,and 25 at 18 mo postoperatively.Most scales of quality of life and bowel function improved significantly over time.Urgency persisted to a high degree throughout the period without a significant change over time.The use of medications for defecation was about 10%over the entire period.Gas(P=0.023)and fecal frequency(P<0.001)increased,and bowel dysfunction group(P=0.028)was more common among patients taking medication.At six months,resected bowel and colon lengths were significantly different as a risk factor between the dysfunction group and the no dysfunction group[odd ratio(OR):1.095,P=0.026;OR:1.147,P=0.031,respectively]in univariate analysis,but not in multivariate analysis.CONCLUSION Despite D3 lymphadenectomy,most bowel symptoms improved over time after right-sided colectomy using a minimally invasive approach,and continuous medication was needed in only approximately 10%of patients.
文摘目的:探讨高龄右半结肠癌患者行腹腔镜全结肠系膜切除术的安全性、可行性。方法:回顾分析2006年1月至2017年1月收治的189例70岁以上右半结肠癌患者的临床资料,其中108例接受腹腔镜全结肠系膜切除术(研究组),81例接受腹腔镜传统结肠癌根治术(对照组),比较两组患者术前情况、手术相关指标及术后恢复指标。结果:两组患者术前一般情况差异均无统计学意义(P>0.05),两组均无手术相关死亡病例。研究组、对照组中转开腹率(4.6%vs. 4.9%)、手术时间[(174.3±47.4) min vs.(167.2±57.9) min]、术中出血量[(89.9±72.8) mL vs.(98.8±67.6) mL]、排气时间[(2.7±1.1) d vs.(3.0±1.3) d]、进食流质时间[(2.8±1.5) d vs.(3.2±1.9) d]、住院时间[(10.4±4.5) d vs.(11.2±5.5) d]、术后并发症发生率(21.3%vs.23.5%)差异均无统计学意义(P>0.05)。研究组淋巴结获取数量[(15.6±4.8) vs.(12.8±4.5)]多于对照组(P<0.01)。结论:腹腔镜全结肠系膜切除术治疗高龄右半结肠癌是安全、可行的,可取得更好的肿瘤学近期疗效。
文摘目的探讨腹腔镜辅助根治性右半结肠切除术的临床应用效果。方法回顾性分析揭阳市人民医院普通外科一区2013年8月至2017年8月收治的95例右半结肠癌根治术患者的临床资料,根据手术方式不同将患者分为腹腔镜组47例和开腹组48例。腹腔镜组采用腹腔镜辅助根治性右半结肠切除术,开腹组采用常规开腹手术,比较两组患者的手术情况(手术时间、切口长度、术中出血量)、术中淋巴结清扫情况(肠系膜根部淋巴结清扫数、阳性淋巴结检出率)、术后肠道功能恢复情况(术后肛门首次排气排便时间、腹胀腹痛持续时间、住院时间),以及术后并发症的发生和肿瘤复发转移情况。结果腹腔镜组与开腹组患者的手术时间[(156.51±16.62) min vs (126.62±15.51) min]、术中出血量[(85.52±15.73) mL vs (100.85±18.95) mL]和切口长度[(5.23±0.65) cm vs (18.52±3.68) cm]比较,腹腔镜组手术时间长于开腹组,术中出血量少于对照组,切口长度小于对照组,差异均有统计学意义(P<0.05);腹腔镜组与开腹组患者的淋巴结清扫数目[(5.01±1.60)个 vs (5.22±1.57)个]和阳性淋巴结比例(8.51% vs 10.42%)比较,差异均无统计学意义(P>0.05);腹腔镜组与开腹组患者的首次排气时间[(2.21±1.28) d vs (3.82±1.51) d]、首次排便时间[(2.51±1.76) d vs (4.58±1.82) d]、腹痛腹胀持续时间[(2.01±0.82) d vs (3.59±1.57) d]、住院时间[(7.15±2.08) d vs(15.35±3.65) d]比较,腹腔镜组均明显短于开腹组,差异均有统计学意义(P<0.05);腹腔镜组与开腹组患者术后肿瘤复发率分别为2.13%和 2.08%、转移率分别为4.26%和6.25%,差异均无统计学意义(P>0.05)。结论腹腔镜辅助根治性右半结肠切除术具有和开腹手术同样的临床疗效,且微创、利于术后恢复。
