手辅式腹腔镜右半结肠癌根治术在肥胖患者中的应用  

Clinical study of hand-assisted laparoscopic right hemicolectomy for right colon carcinoma in obesity patients

作　　者：徐波[1] 戴丽华[1] 朱光辉[1] 翁杰锋[1] 

机构地区：[1]广州市第一人民医院普外科,广州510180

出　　处：《国际外科学杂志》2007年第11期736-739,共4页International Journal of Surgery

摘　　要：目的探讨手辅式腹腔镜右半结肠癌根治术在肥胖患者中的疗效及应用价值。方法回顾分析在我院行手辅式腹腔镜右半结肠癌根治术的肥胖患者22例，并与同期行开腹右半结肠癌根治术的肥胖患者28例进行比较，对比两组的手术安全性、术后恢复情况。结果两组均无术中术后严重并发症和手术死亡病例，手辅式腹腔镜组无一例中转开腹；手辅式腹腔镜组手术时间与开腹组差异无显著意义（P〉0．05）；手辅式腹腔镜组术中出血量少、术后体温恢复快、排气快、下床活动早，术后住院时间短，术后并发症少，与开腹组相比差异有显著性（P〈0．01）；手辅式腹腔镜组手术切除标本长度及清扫淋巴结总数分别与开腹组无显著性差异（P〉0．05）。结论运用手辅式腹腔镜技术能集中开放和腹腔镜手术的优势完成复杂的手术，手辅式腹腔镜右半结肠癌根治术对肥胖患者是一种安全、有效的手术方式，能体现出微创的优势，有较高的临床应用价值。Objective To study the clinical application of hand-assisted laparoscopic right hemlcolectomy for right colon carcinoma in obesity patients. Methods Twenty-two obesity cases underwent hand-assisted laparoscopic right hemicolectomy were retrospectively reviewed, and compared with 28 obesity cases with transabdominal right hemicolectomy in the same period. Results In hand-assisted laparoscopic group, there were less bleeding loss, earlier recovery to normal temperature and gastrointestinal function, earlier out of bed activity and eating, shorter hospitalization and less complications, when compared with transabdominal group（P 〈0.01）. The operative time was not different between the two groups（P 〉0.05）. No significant difference was observed, for the oncological clearance, in terms of the number of lymph nedes removed and length of specimen （P 〉 0.05）. Conclusions This hand-assisted laparoscopic approach with HandPort system can make best use of the advantages of both open and laparoscopic surgery. Hand-assisted laparoscopic right hemicolectomy for right colon carcinoma is a safe and available method for obesity patients, achieving the goal of minimally invasive surgery.

关 键 词：腹腔镜 结肠癌 肥胖 

分 类 号：R735[医药卫生—肿瘤] R589[医药卫生—临床医学]