腹腔镜右半结肠切除尾侧入路与头侧入路的前瞻性随机对照研究  

A Prospective Randomized Control Trial of the Approach for Laparoscopic Right Hemi-colectomy:Caudal-to-Cranial versus Cranial-to-Caudal

作　　者：肖荷芳[1] 陈子文[1] 刘红权[1] 方传发[1] 刘传渊[1] 赖承治[1] 钟武[1] XIAO Hefang;CHEN Ziwen;LIU Hongquan;FANG Chuanfa;LIU Chuanyuan;LAI Chengzhi;ZHONG Wu(Department of Gastroenterology,Ganzhou People s Hospital,Ganzhou 341000,China)

机构地区：[1]赣州市人民医院,江西赣州341000

出　　处：《现代医院》2018年第11期1654-1657,共4页Modern Hospitals

基　　金：赣州市科技局指导性科技计划项目(GZ 2017ZSF203)

摘　　要：目的比较尾侧入路与头侧入路在右半结肠癌行腹腔镜右半结肠切除术的近期疗效。方法于2017年1月—2018年7月,将入院拟行手术治疗的38例右半结肠癌患者按随机数字表前瞻性随机分为两组(各19例),分别行尾侧入路和头侧入路腹腔镜右半结肠切除术,比较两组手术时间、术中出血量、淋巴结清扫情况、术中及术后并发症。结果尾侧入路与头侧入路两组患者手术时间分别为(121. 4±25. 2)及(152. 1±31. 7) min,术中出血量分别为(52. 4±25. 2)及(82. 4±30. 8) mL,差异均有统计学意义,淋巴结清扫数目分别为(17. 8±4. 1)和(17. 3±3. 8)枚,术中并发症各有1例,术后并发症有2例及1例,差异均无统计学意义。结论尾侧入路较头侧入路在腹腔镜右半结肠切除术中可明显缩短手术时间,减少术中出血量,简便、安全和易掌握,值得临床推广。Objective To compare the caudal-to-cranial approach with cranial-to-caudal approach in laparoscopic right hemi-colectomy for right colon cancer. Methods A prospective randomized controlled trial was performed in Ganzhou people’s Hospital between January 2017 to July 2018. Thirty-eight cases with right colon cancer were randomly divided into two groups： caudal-to-cranial laparoscopic right hemi-colectomy and cranial-to-caudal laparoscopic right hemi-colectomy. These two groups were compared in view of operation time, intraoperative blood loss, lymph node dissection, intraoperative and postoperative complications. Results Comparing caudal-to-cranial approach with cranial-to-caudal approach, we got statistics： operation time in both groups were respectively （121.4±25.2）min and （152.1±31.7）min; intraoperative blood loss, respectively （52.4±25.2）mL and （82.4±30.8）mL. There were statistically significant differences. The number of lymph node dissection was （17.8±4.1） vs. （17.3±3.8）, respectively. 1 case ended up with intraoperative complications and 2 cases with postoperative complications in caudal-to-cranial approach. 1 case developed with intraoperative complications and 1 with postoperative complications for the group with the cranial-to-caudal approach, the differences not statistically significant. Conclusion Compared with cranial-to-caudal approach, caudal-to-cranial approach can significantly shorten operation time, and reduce intraoperative blood loss. It is simple, safe and easy for application, so it is worthy of clinical promotion.

关 键 词：结肠肿瘤 腹腔镜右半结肠切除术 手术入路 随机对照研究 

分 类 号：R735.35[医药卫生—肿瘤] R730.56[医药卫生—临床医学]