腹腔镜下不同入路右半结肠癌根治术治疗效果比较  

Comparative study of different approaches of laparoscopic surgery in treating right semi-colon cancer

作　　者：顾德智[1] 王正冬[1] 

机构地区：[1]江苏连云港市第一人民医院胃肠外科,222002

出　　处：《中华普外科手术学杂志（电子版）》2017年第6期507-509,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的比较腹腔镜下右半结肠癌根治术采取不同入路方式的治疗效果和安全性,为腹腔镜下右半结肠癌根治术的入路方式选择提供参考。方法 2013年3月至2016年3月收治的78例右半结肠癌患者为研究对象,随机分为动脉优先入路组和传统侧方入路组(每组39例),比较两组的治疗效果。所有数据采用SPSS18.0进行分析,两组患者手术情况、恢复情况以(x珋±s)表示,并采用配对t检验;并发症发生率采用χ2检验,以P<0.05为差异有统计学意义。结果动脉优先入路组术中出血量、术后腹腔引流量均低于传统侧方入路组,其淋巴结清扫数量高于后者,差异有统计学意义(P<0.05)。动脉优先入路组术中、术后并发症发生率分别为7.7%、5.1%,与传统侧方入路组的5.1%、10.3%比较,差异无统计学意义(P>0.05)。两组患者均获得有效随访,未见术后30 d再住院及病死者,术后6个月复查肠镜、全腹CT亦未见肿瘤局部复发或远处转移。结论腹腔镜下动脉优先入路、传统侧方入路治疗右半结肠癌均有着确切的疗效,动脉优先入路法在淋巴结清扫数量及术后恢复情况方面具有更为明显的优势,且手术难度更低,推广前景良好。Objective To compare the therapeutic effect and satety of different approaches of laparoscopic surgery in treating right semi-colon cancer , and to provide a clinical reference . Methods From March 2013 to March 2016, 78 patients with right semi-colon cancer were enrolled into this study, who were random divided into arterial priority approach group （ n =39 ） and traditional lateral approach group （ n=39 ） .Therapeutic effect of patients in two groups were compared .Statistical analysis were performed by using SPSS 18.0 software.Measurement data, such as operation and recovery indicators were expressed as （ x-±s） and were examined by t test.Count data such as postoperative complications rate were examined by chi square test , A P value of 〈0.05 was considered as statistically significant . Results Compared with traditional lateral approach group , there were less intraoperative blood loss , less postoperative drainage amount and more harvested lymph nodes in priority approach group , with, significant difference （P〈0.05）.The incidence of intraoperative and postoperative complications in arterial priority approach group was 7.7% and 5.1%, while 5.1% and 10.3% in the traditional lateral approach group respectively, without significant difference （P〉0.05）.In both groups follow-up were completed.There were no 30-days death and rehospitalization after operation , and no recurrence or distant metastasis within six month examined by colonoscopy and full abdomen CT . Conclusion Boht arterial priority approach and traditional lateral approach in laparoscopic right semi-colectomy could achieve curative effect .However more harvested lymph nodes and better recovery could be achieved by using arterial priority approach with less operation difficulty, which has good prospects for clinical promotion .

关 键 词：结肠肿瘤 腹腔镜检查 治疗结果 安全 

分 类 号：R735.35[医药卫生—肿瘤]