减孔腹腔镜辅助右半肠切除术治疗老年患者的临床疗效分析  

Clinical efficacy of reduced incision laparoscopic-assisted right hemicolectomy in the elderly patients with right colon cancer

作　　者：陈匡荣[1] 张宏伟[1] Chen kuangrong;Zhang hongwei(Department of general surgery,The first people's Hospital of Ziyang,Sichuan,Ziyang 641300,China)

机构地区：[1]资阳市第一人民医院普外科,四川641300

出　　处：《中华普外科手术学杂志（电子版）》2018年第2期168-171,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨减孔腹腔镜辅助右半肠切除术治疗老年患者的临床疗效。方法回顾性分析2012年1月至2014年1月收治的86例老年右半结肠癌患者的临床资料,根据手术方式分为2孔组(45例)和5孔组(41例),采用SPSS22.0软件对所有数据进行统计学分析,手术效果及术后恢复相关指标以(x珋±s)表示,采用独立t检验;术后并发症发生率、3年内复发率和病死率等组间比较采用χ2检验,均以P<0.05为差异有统计学意义。结果 2孔组腹部切口总长度明显短于5孔组,术后第1 d、2 d、3 d的疼痛评分明显低于5孔组,术后首次通气时间、术后下床活动时间明显短于5孔组(P<0.05);两组患者手术时间、拔除尿管时间、术中出血量、平均住院时间、淋巴结清扫数目、远近切缘距肿瘤距离比较,差异均无统计学意义(均P>0.05)。两组患者术后并发症发生率、3年内复发率和病死率比较,差异均无统计学意义(均P>0.05)。结论减孔腹腔镜辅助右半肠切除术治疗老年右半结肠癌是安全可行的,具有术后疼痛轻、美容效果好的优势,值得在临床中进一步推广应用。Objective To investigate the clinical efficacy of reduced incision laparoscopic-assisted right hemicolectomy in the elderly patients with right colon cancer. Methods The clinical data of 86 elderly patients with right colon cancer admitted into our hospital from January 2012 to January 2014 were analyzed retrospectively.According to surgical procedures,the patients were divided into two-port group(45 patients)and five-port group(41 patients).SPSS22.0 software was used for data analysis,the operation effect indicators and post-operative recovery indicators were expressed as(±s),and compared by using Student's t test.The post-operative complication rate,recurrence rate and mortality rate within 3 years were compared by using the Chi-square test.P<0.05 was considered statistically significant.Results Two-port group had shorter length of abdominal incisions(P<0.05);Postoperative pain scores were lower in the two-port group at 1d,2d,3d(P<0.05);The first flatus time,ground activity time in the two-port group were significantly shorter than those in the five-port group(P<0.05);No significant difference was observed in operation time,catheter removal time,intraoperative blood loss,average hospitalization time,number of removed lymph nodes,proximal margin length,distal margin length between the two groups(P>0.05).No significant difference was observed in postoperative complication rate,recurrence rate and mortality rate within 3 year between the two groups(P>0.05).Conclusion Reduced incision laparoscopic-assisted right hemicolectomy in the treatment of elderly patients with right colon cancer is feasible and safe,and has the benefits of less postoperative pain,better cosmetic effect,which is valuable to be applied in clinical.

关 键 词：结直肠肿瘤 腹腔镜检查 结肠切除术 治疗结果 

分 类 号：R735.35[医药卫生—肿瘤]