腹腔镜辅助右半结肠切除术治疗结肠癌67例分析  

Clinical effect of laparoscopic-assisted right hemicolectomy in 67 patients with colon cancer

作　　者：陈林[1] 陈文柏[1] 王震[1] 

机构地区：[1]湖北省荆州市江陵县人民医院普外二科,江陵434100

出　　处：《中国肿瘤临床与康复》2013年第7期759-761,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨腹腔镜辅助下右半结肠切除术治疗结肠癌的临床效果。方法 134例结肠癌患者随机分为观察组(67例)与对照组(67例),观察组给予腹腔镜辅助右半结肠切除术治疗,对照组给予常规开腹手术治疗,对比两组临床效果、术中情况及术后并发症发生率。结果两组患者均手术成功,观察组患者无中转开腹手术者;观察组患者的手术时间(145.4±31.2)min,显著长于对照组(102.6±29.8)min(P<0.05),术中出血量(103.6±39.8)ml,显著少于对照组(279.4±40.3)ml(P<0.05),术后排气时间(2.3±1.4)h、术后下床时间(3.3±1.6)d及总住院时间(11.3±4.8)d,均显著短于对照组的(4.6±1.6)h,(5.2±1.4)d及(15.4±5.2)d(均P<0.05),两组患者术中清扫淋巴结数目分别为(15.2±3.6)个和(14.7±3.4)个,差异无统计学意义,(均P>0.05);观察组患者术后并发症发生率为6.0%,显著低于对照组的23.9%(P<0.05);两组患者术后1年生存率、局部复发率及远处转移率差异均无统计学意义(均P>0.05)。结论腹腔镜辅助右半结肠切除术治疗结肠癌患者中疗效与常规开腹手术相似,但损伤较小,术后康复较快,值得推广。Objective To study the clinical effect of laparoscopic-assisted right hemicolectomy in patients with colon cancer.Methods 134 patients with colon cancer were randomly devided into the observation group（67 cases） and the control group（67 cases）.The observation group was treated with laparoscopic-assisted right hemicolectomy,and the control group conventional laparotomy.The clinical effects,surgery indicators,and the incidence of postoperative complications were compared.Results Patients in the two groups were all performed successfully,there was no patients converted to laparotomy.For the observation group,Operative time（145.4±31.2）min was significantly longer than the control group（102.6±29.8）min（P0.05）.Blood loss（103.6±39.8）ml,significantly less than（279.4±40.3）ml（P0.05）.Postoperative anal exhaust time（2.3±1.4）h,ambulation time（3.3±1.6）d,and the total length of stay（11.3±4.8）d,were significantly shorter than that of the control group（4.6±1.6h,5.2±1.4d and 15.4±5.2d respectively,P0.05）.There was no significant difference in lymphadenectomy intraoperative（15.2±3.6 vs 14.7±3.4,P0.05）.The incidence of postoperative complications of the observation group（6.0%） was significantly lower than the control group（23.9%,P0.05）.There was no significant difference in 1-year survival rate after surgery,the local recurrence rate,and the rate of distant metastasis（P0.05）.Conclusions Laparoscopic-assisted right hemicolectomy can obtain similar efficacy with conventional open surgery in patients with colon cancer,but with minimum trauma and faster postoperative recovery simultaneously.it＇s worthy of promotion.

关 键 词：腹腔镜 右半结肠切除术 结肠肿瘤 

分 类 号：R735.35[医药卫生—肿瘤]