腹腔镜下完整系膜切除术治疗右半结肠癌手术路径和临床疗效观察  

The surgical pathways and clinical efficacy of laparoscopic total mesorectal excision in the treatment of right colon cancer

作　　者：谢容明[1] 魏文波[1] 陈新桂[1] XIE Rongming WEI Wenbo CHEN Xingui(The First Department of General Surgery,Jieyang People＇ s Hospital of Guangdong Province,Jieyang 522000,Chin)

机构地区：[1]广东省揭阳市人民医院普外一科,广东揭阳522000

出　　处：《中国医药科学》2017年第22期193-196,共4页China Medicine And Pharmacy

摘　　要：目的探讨腹腔镜下完整系膜切除术治疗右半结肠癌手术路径,并分析其临床疗效。方法选择2013年6月~2016年6月本院收治的右半结肠癌患者80例,以随机数字表法分为两组,各40例,对照组行常规开腹结肠癌根治术,观察组则实施腹腔镜下完整性全结肠系膜切除手术治疗,比较两组术后大便成形时间、规律大便时间,统计胃肠功能恢复时间,如肠鸣音恢复正常时间、肛门排气时间及肛门排便时间,随访1年,比较两组复发例数(率)及转移例数(率),绘制1年生存曲线。结果观察组术后大便成形排出时间早于对照组(P<0.05),大便规律排出时间显著早于对照组(P<0.05),干预后,观察组肠鸣音恢复正常时间早于对照组(P<0.05),肛门排气时间早于对照组(P<0.05),排便时间早于对照组(P<0.05),随访1年期间,观察组复发例数(率)及转移例数(率)均显著低于对照组(P<0.05)。观察组1年生存率高于对照组(P<0.05)。结论针对右半结肠癌患者行腹腔镜下完整性肠系膜切除,可有效的提高患者术后胃肠功能,促进排便功能恢复,并减少术后复发及转移率进而延长患者生存时间。Objective To investigate the surgical pathways of laparoseopie total mesoreetal excision for right colon cancer, and to analyze its clinical efficacy. Methods 80 patients with right colon cancer who were treated in our hospital from June 2013 to June 2016 were selected.They were divided into two groups according to the principle of random number,40 cases in each group.The control group received routine laparotomy and radical resection of colon cancer,while the observation group received laparoseopic total mesorectal excision.The time of defecation,regular defecation time and the recovery time of gastrointestinal function were compared between the two groups,such as the bowel sound recovery time,anal exhaust time and defecation time.After 1 years of follow-up,the number of recurrence （rate） and the number of metastasis eases （rate） were compared,and the 1 year survival curve was plotted. Results The defecation time of the observation group was earlier than that of the control group （P 〈 0.05）,and the regular time of defecation was significantly earlier than that of the control group （P 〈 0.05）.After the intervention, the bowel sounds recovery time of the observation group was earlier than that of the control group （P 〈 0.05）,anal exhaust time was earlier than that of the control group （P 〈 0.05）,defecation time was earlier than that of the control group （P 〈 0.05）. During the follow-up period of 1 years,the number of recurrent cases （rate） and the number of metastasis cases （rate） in the observation group were significantly lower than those in the control group （P 〈 0.05）.The 1 year survival rate of the observation group was higher than that of the control group （P 〈 0.05）. Conclusion The laparoscopic complete mesenteric resection for the patients with right colon cancer can effectively improve the gastrointestinal function of patients, promote bowel function recovery,and reduce the postoperative recurrence and metastasis rate and prolong the survival time

关 键 词：腹腔镜 完整系膜切除术 右半结肠癌 手术路径 

分 类 号：R735.35[医药卫生—肿瘤]