手助腹腔镜与腹腔镜辅助结直肠癌根治术的对比研究  

Comparative study of hand-assisted laparoscopy and laparoscopic-assisted radical operation for colorectal cancer

作　　者：李伟学[1,2] 邬善敏[1] 曾涛[2] 

机构地区：[1]武汉大学人民医院,湖北武汉430060 [2]武汉科技大学附属汉阳医院

出　　处：《腹腔镜外科杂志》2016年第3期181-184,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨手助腹腔镜与腹腔镜辅助结直肠癌根治术的疗效。方法:选取2012年4月至2015年1月收治的63例结直肠癌根治术患者,按照随机数字表法分为腹腔镜辅助组(A组,n=31)与手助腹腔镜组(B组,n=32),对比两组手术相关指标、术后疼痛、术后并发症、切口满意度。结果:B组手术时间、手术出血量、引流量均低于A组(P<0.01),胃肠功能恢复时间较A组长(P<0.01)。两组术后治疗费用、住院时间、并发症发生率差异无统计学意义(P>0.05)。B组术后疼痛VAS评分显著高于A组(P<0.01)。B组切口满意度评分低于A组(P<0.01)。结论:在结直肠癌根治术中,手助腹腔镜手术具有手术时间短、术中出血量低、降低手术中转率、学习曲线短等优点,但腹腔镜辅助手术在术后胃肠功能恢复、术后疼痛、切口满意度方面更具优势,在临床应用时应依据实际情况合理选取腹腔镜手术。Objective： To investigate the therapeutic effect of hand-assisted laparoscopy and laparoscopic-assisted radical operation for colorectal cancer. Methods： From Apr. 2010 to Jan. 2015,63 patients who suffered from colorectal cancer and underwent radical operation were selected and divided into the laparoscopic-assisted group（ group A,n = 31） and hand-assisted laparoscopic group（ group B,n = 32） according to random number table. Operation index,postoperative pain,postoperative complications,incision satisfaction score of two groups were compared. Results： Operation time,blood loss,drainage volume of group B were shorter than those of group A（ P 0. 01）. Recovery time of gastrointestinal function of group B was longer than that of group A（ P 0. 01）. There were no significant differences in the treatment costs,hospital stay and postoperative complications（ P 0. 05）. VAS score of group B was higher than that of group A（ P 0. 01）. Incision satisfaction score of group B was lower than that of group A（ P 0. 01）. Conclusions： In radical operation for colorectal cancer,hand-assisted laparoscopic surgery has advantages such as short operation time,little blood loss,low incidence of conversion to laparotomy and short learning curve,laparoscopic-assisted surgery has advantages in postoperative recovery of gastrointestinal function,postoperative pain,incision satisfaction. The laparoscopic operation should be selected according to the actual situation in clinical use.

关 键 词：结直肠肿瘤 结直肠癌根治术 腹腔镜检查 手辅助 对比研究 

分 类 号：R735.34[医药卫生—肿瘤]