经脐取标本并脐整形术在腹腔镜乙状结肠癌根治术中应用的对比研究  

Comparative study of transumbilical specimens and umbilical plastic operation in laparoscopic radical operation of sigmoid colon carcinoma applications

作　　者：龚杰 黄雄[2] 何山[3] 卜君[3] 徐尔侃[3] 邓亨怡[3] Jie Gong;Xiong Huang;Shan He;Jun Bu;Er-kan Xu;Heng-yi Deng(Department of General Surgery,Leshan People’s Hospital,Leshan,Sichuan 614000,China;Department of General Surgery,the Sixth People’s Hospital,Chengdu,Sichuan 610000,China;Department of General Surgery,the Second People’s Hospital of Chengdu Affiliated to Zunyi Medical College,Chengdu,Sichuan 610017,China)

机构地区：[1]四川省乐山市人民医院普外一科,四川乐山614000 [2]四川省成都市第六人民医院普外科,四川成都610000 [3]遵义医学院附属成都市第二人民医院普外科,四川成都610017

出　　处：《中国内镜杂志》2018年第10期16-25,共10页China Journal of Endoscopy

基　　金：四川省科技支撑计划项目(No:2012SZ0194)

摘　　要：目的探讨腹腔镜乙状结肠癌根治经脐取标本并脐整形术的临床优势及应用前景。方法按完全随机化原则将遵义医学院附属成都市第二人民医院普外科2015年1月-2016年12月收治的60例乙状结肠癌患者分为试验组和对照组(该研究采用随机数字表法进行分组)。试验组30例患者行腹腔镜乙状结肠癌根治经脐取标本并脐整形术,对照组30例患者同期行传统腹腔镜乙状结肠癌根治术。比较两组手术的安全性、近期临床疗效、肿瘤根治性、术后相关并发症及美容效果等。结果两组患者的性别、年龄、体质指数(BMI)、Dukes分期、原发肿瘤部位及术前病理分类等比较差异无统计学意义(P>0.05),具有可比性。两组手术时间、术中失血量、术后肠功能恢复时间、开始进食时间、术后首次下床活动时间、住院时间和住院费用等比较差异无统计学意义(P>0.05)。试验组术后镇痛剂的使用率为30.00%,对照组为56.67%,两组间比较差异具有统计学意义(P <0.05)。两组肿瘤大小、标本长度、远切缘距离和淋巴结清扫数目等比较差异无统计学意义(P>0.05)。两组术后相关并发症比较差异无统计学意义(P>0.05)。试验组的切口长度明显短于对照组,两组间比较差异有统计学意义(P <0.05)。试验组的术后视觉模拟评分(VAS)明显低于对照组,两组间比较差异有统计学意义(P <0.05)。试验组患者对切口的满意率为90.00%,对照组为63.33%,两组间比较差异具有统计学意义(P <0.05)。试验组术后腹壁疤痕隐蔽难以察觉,且肚脐形态稳定持久,近、远期美容效果满意。结论腹腔镜乙状结肠癌根治经脐取标本并脐整形术安全、可行,操作不复杂,创伤小,疼痛轻,腹壁美容效果显著,患者满意度高,值得临床推广。Objective To evaluate the clinical advantages and application prospects of laparoscopic radical operation and took out the specimens through the umbilicus and umbilical plastic surgery of sigmoid colon carcinoma.Methods In this research,60 cases of sigmoid colon cancer patients were divided into test group and control group by random number table method from January,2015 to December,2016.30 patients operated(test group)by laparoscopy radical operation and transumbilical specimens and umbilical plastic operation,and 30 patients operated(control group)by traditional laparoscopy radical operation at same time on sigmoid colon carcinoma.Then compare the operation safety,short-term effect,tumor radical degree,postoperative complications and cosmetic effect between the two groups.Results No significant difference between the two groups of patients were comparable for age,gender,body mass index,Dukes stages,primary tumor location and preoperative pathological classification(P>0.05).Two groups are comparable for operation time,intraoperative blood loss,intestinal function recovery time,the time of first feeding,time of first ambulation,hospitalization time,hospitalization expenses were no significant difference(P>0.05).The rate of postoperative analgesic use cases were 30.00%in the test group and 56.67%in the control group,the difference between the two groups were statistically significance(P<0.05).There were no significant differences in tumor size,length of specimen,distance of far cutting edge,number of lymph node dissection(P>0.05).The two groups are comparable for postoperative complications have no significant difference(P>0.05).The test group incision length was significantly shorter than that of the control group,the difference between the two groups was statistically significance(P<0.05).The score of VAS pain in test group was significantly lower than that in the control group,the difference between the two groups was statistically significance(P<0.05).The satisfaction rate of the patients were satisfying for i

关 键 词：腹腔镜 乙状结肠癌根治术 经脐取标本 脐整形术 

分 类 号：R656.9[医药卫生—外科学]