Objective: To investigate the short-term efficacy of laparoscopic radical resection of right-sided colon cancer with two different surgeon positions and trocar placements. Methods: The data of 78 patients who underwen...Objective: To investigate the short-term efficacy of laparoscopic radical resection of right-sided colon cancer with two different surgeon positions and trocar placements. Methods: The data of 78 patients who underwent laparoscopic radical resection of right-sided colon cancer between January 2018 and August 2019 were retrospectively analysed. The surgical method was selected by the patients. The patients were divided into two groups according to the surgeons’ positioning habits and trocar placements. The group with the lead surgeon standing between the patient’s legs had 35 patients, and the group with the lead surgeon standing at the left side of the patient had 43 patients. The operation time, intraoperative blood loss, postoperative anal gas evacuation time, postoperative urinary catheter indwelling time, postoperative hospital stay, C-reactive protein (CRP) level on the first day after surgery, and postoperative pathological data and complications were compared between the two groups. Results: All patients underwent the laparoscopic radical resection of right-sided colon cancer, none converting to laparotomy. No significant difference (P > 0.05) in intraoperative blood loss (57.6 ± 21.3 ml vs 60.2 ± 35.3 ml), postoperative anal gas evacuation time (3.5 ± 1.1 d vs 3.8 ± 1.3 d), postoperative urinary catheter indwelling time (2.6 ± 1.3 d vs 2.4 ± 1.2 d), postoperative hospital stay (7.1 ± 1.8 d vs 7.5 ± 2.1 d), or CRP level on the first day after surgery (54.7 ± 9.6 mg/L vs 53.9 ± 8.2 mg/L) was detected between the two groups. The operation time was shorter in the group with the lead surgeon standing between the patient’s legs (185.2 ± 25.6 min vs 196.2 ±19.7 min) (P < 0.05). The two groups did not differ significantly in the tumour length (4.2 ± 1.3 cm vs 3.9 ± 1.5 cm), number of dissected lymph nodes (27.5 ± 11.6 vs 25.1 ± 15.4), pathological type, or postoperative pathological tumour-node-metastasis stage (P > 0.05). No patients died or had anastomotic fistula during their postoperative hospital stay, and the incidence of postoperative complications did not differ between the two groups (22.9% (8/35) vs 23.3% (10/42);P > 0.05). Conclusion: Under the principle of radical resection, the surgeon should adopt the most suitable standing position and trocar placement according to the specific situation. If the surgeon stands between the patient’s legs, this might shorten the operation time and promote a smoother surgery.展开更多
AIM: to evaluate the feasibility, safety, and oncologic outcomes of laparoscopic extended right hemicolectomy (LERH) for colon cancer. METHODS: Since its establishment in 2009, the Southern Chinese Laparoscopic Colore...AIM: to evaluate the feasibility, safety, and oncologic outcomes of laparoscopic extended right hemicolectomy (LERH) for colon cancer. METHODS: Since its establishment in 2009, the Southern Chinese Laparoscopic Colorectal Surgical Study (SCLCSS) group has been dedicated to promoting patients' quality of life through minimally invasive surgery. The multicenter database was launched by combining existing datasets from members of the SCLCSS group. The study enrolled 220 consecutive patients who were recorded in the multicenter retrospective database and underwent either LERH (n = 119) or open extended right hemicolectomy (OERH) (n = 101) for colon cancer. Clinical characteristics, surgical outcomes, and oncologic outcomes were compared between the two groups. RESULTS: There were no significant differences in terms of age, gender, body mass index (BMI), history of previous abdominal surgery, tumor location, and tumor stage between the two groups. The blood loss was lower in the LERH group than in the OERH group [100 (100-200) mL vs 150 (100-200) mL, P < 0.0001]. The LERH group was associated with earlier first flatus (2.7 +/- 1.0 d vs 3.2 +/- 0.9 d, P < 0.0001) and resumption of liquid diet (3.6 +/- 1.0 d vs 4.2 +/- 1.0 d, P < 0.0001) compared to the OERH group. The postoperative hospital stay was significantly shorter in the LERH group (11.4 +/- 4.7 d vs 12.8 +/- 5.6 d, P = 0.009) than in the OERH group. The complication rate was 11.8% and 17.6% in the LERH and OERH groups, respectively (P = 0.215). Both 3-year overall survival [LERH (92.0%) vs OERH (84.4%), P = 0.209] and 3-year disease-free survival [LERH (84.6%) vs OERH (76.6%), P = 0.191] were comparable between the two groups. CONCLUSION: LERH with D3 lymphadenectomy for colon cancer is a technically feasible and safe procedure, yielding comparable short-term oncologic outcomes to those of open surgery. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.展开更多
目的探讨行腹腔镜下右半结肠癌根治术患者消化道重建时使用倒刺线关闭共同开口及加固吻合口的有效性和安全性。方法选择2021年1月至2022年12月于河南省肿瘤医院行右半结肠癌根治术患者82例为研究对象。根据术中消化道重建方法将患者分...目的探讨行腹腔镜下右半结肠癌根治术患者消化道重建时使用倒刺线关闭共同开口及加固吻合口的有效性和安全性。方法选择2021年1月至2022年12月于河南省肿瘤医院行右半结肠癌根治术患者82例为研究对象。根据术中消化道重建方法将患者分为对照组(n=40)和观察组(n=42)。对照组患者术中使用直线切割闭合器关闭共同开口,吻合口不加固;观察组患者术中使用倒刺线关闭共同开口及加固吻合口。比较2组患者消化道重建时间、使用钉仓的数量、术中出血量等手术相关指标,比较2组患者术后排气时间、术后住院时间和手术前后24 h血红蛋白(Hb)差值;记录并比较2组患者术后并发症发生率。结果观察组患者消化道重建时间长于对照组,使用钉仓数少于对照组(P<0.05);2组患者术中出血量比较差异无统计学意义(P>0.05)。2组患者术后排气时间、术后住院时间比较差异无统计学意义(P>0.05)。观察组患者手术前后24 h Hb差值小于对照组(P<0.05)。对照组和观察组患者术后并发症发生率分别为7.1%(3/42)和12.5%(5/40),2组患者并发症发生率比较差异无统计学意义(χ^(2)=0.799,P>0.05)。结论使用倒刺线关闭共同开口及加固吻合口是一种安全、可行且止血效果较好的消化道重建方法。展开更多
文摘Objective: To investigate the short-term efficacy of laparoscopic radical resection of right-sided colon cancer with two different surgeon positions and trocar placements. Methods: The data of 78 patients who underwent laparoscopic radical resection of right-sided colon cancer between January 2018 and August 2019 were retrospectively analysed. The surgical method was selected by the patients. The patients were divided into two groups according to the surgeons’ positioning habits and trocar placements. The group with the lead surgeon standing between the patient’s legs had 35 patients, and the group with the lead surgeon standing at the left side of the patient had 43 patients. The operation time, intraoperative blood loss, postoperative anal gas evacuation time, postoperative urinary catheter indwelling time, postoperative hospital stay, C-reactive protein (CRP) level on the first day after surgery, and postoperative pathological data and complications were compared between the two groups. Results: All patients underwent the laparoscopic radical resection of right-sided colon cancer, none converting to laparotomy. No significant difference (P > 0.05) in intraoperative blood loss (57.6 ± 21.3 ml vs 60.2 ± 35.3 ml), postoperative anal gas evacuation time (3.5 ± 1.1 d vs 3.8 ± 1.3 d), postoperative urinary catheter indwelling time (2.6 ± 1.3 d vs 2.4 ± 1.2 d), postoperative hospital stay (7.1 ± 1.8 d vs 7.5 ± 2.1 d), or CRP level on the first day after surgery (54.7 ± 9.6 mg/L vs 53.9 ± 8.2 mg/L) was detected between the two groups. The operation time was shorter in the group with the lead surgeon standing between the patient’s legs (185.2 ± 25.6 min vs 196.2 ±19.7 min) (P < 0.05). The two groups did not differ significantly in the tumour length (4.2 ± 1.3 cm vs 3.9 ± 1.5 cm), number of dissected lymph nodes (27.5 ± 11.6 vs 25.1 ± 15.4), pathological type, or postoperative pathological tumour-node-metastasis stage (P > 0.05). No patients died or had anastomotic fistula during their postoperative hospital stay, and the incidence of postoperative complications did not differ between the two groups (22.9% (8/35) vs 23.3% (10/42);P > 0.05). Conclusion: Under the principle of radical resection, the surgeon should adopt the most suitable standing position and trocar placement according to the specific situation. If the surgeon stands between the patient’s legs, this might shorten the operation time and promote a smoother surgery.
基金Supported by National High Technology Research and Development Program of China,No.2012AA021103the Program of Guangdong Provincial Department of Science and Technology,No.2012A030400012+1 种基金the Major Program of Science and Technology Program of Guangzhou,No.201300000087the Sub-project under National Science and Technology Support Program,No.2013BAI05B00
文摘AIM: to evaluate the feasibility, safety, and oncologic outcomes of laparoscopic extended right hemicolectomy (LERH) for colon cancer. METHODS: Since its establishment in 2009, the Southern Chinese Laparoscopic Colorectal Surgical Study (SCLCSS) group has been dedicated to promoting patients' quality of life through minimally invasive surgery. The multicenter database was launched by combining existing datasets from members of the SCLCSS group. The study enrolled 220 consecutive patients who were recorded in the multicenter retrospective database and underwent either LERH (n = 119) or open extended right hemicolectomy (OERH) (n = 101) for colon cancer. Clinical characteristics, surgical outcomes, and oncologic outcomes were compared between the two groups. RESULTS: There were no significant differences in terms of age, gender, body mass index (BMI), history of previous abdominal surgery, tumor location, and tumor stage between the two groups. The blood loss was lower in the LERH group than in the OERH group [100 (100-200) mL vs 150 (100-200) mL, P < 0.0001]. The LERH group was associated with earlier first flatus (2.7 +/- 1.0 d vs 3.2 +/- 0.9 d, P < 0.0001) and resumption of liquid diet (3.6 +/- 1.0 d vs 4.2 +/- 1.0 d, P < 0.0001) compared to the OERH group. The postoperative hospital stay was significantly shorter in the LERH group (11.4 +/- 4.7 d vs 12.8 +/- 5.6 d, P = 0.009) than in the OERH group. The complication rate was 11.8% and 17.6% in the LERH and OERH groups, respectively (P = 0.215). Both 3-year overall survival [LERH (92.0%) vs OERH (84.4%), P = 0.209] and 3-year disease-free survival [LERH (84.6%) vs OERH (76.6%), P = 0.191] were comparable between the two groups. CONCLUSION: LERH with D3 lymphadenectomy for colon cancer is a technically feasible and safe procedure, yielding comparable short-term oncologic outcomes to those of open surgery. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
文摘目的探讨行腹腔镜下右半结肠癌根治术患者消化道重建时使用倒刺线关闭共同开口及加固吻合口的有效性和安全性。方法选择2021年1月至2022年12月于河南省肿瘤医院行右半结肠癌根治术患者82例为研究对象。根据术中消化道重建方法将患者分为对照组(n=40)和观察组(n=42)。对照组患者术中使用直线切割闭合器关闭共同开口,吻合口不加固;观察组患者术中使用倒刺线关闭共同开口及加固吻合口。比较2组患者消化道重建时间、使用钉仓的数量、术中出血量等手术相关指标,比较2组患者术后排气时间、术后住院时间和手术前后24 h血红蛋白(Hb)差值;记录并比较2组患者术后并发症发生率。结果观察组患者消化道重建时间长于对照组,使用钉仓数少于对照组(P<0.05);2组患者术中出血量比较差异无统计学意义(P>0.05)。2组患者术后排气时间、术后住院时间比较差异无统计学意义(P>0.05)。观察组患者手术前后24 h Hb差值小于对照组(P<0.05)。对照组和观察组患者术后并发症发生率分别为7.1%(3/42)和12.5%(5/40),2组患者并发症发生率比较差异无统计学意义(χ^(2)=0.799,P>0.05)。结论使用倒刺线关闭共同开口及加固吻合口是一种安全、可行且止血效果较好的消化道重建方法。
