减孔腹腔镜手术在结直肠癌外科治疗中的应用研究  

Application of Reduced-port Laparoscopic Surgery in Treatment of Colorectal Cancer

作　　者：侯佳宁 郭晨 李岚 邓兴明 熊少伟 崔春淼 HOU Jia-ning;GUO Chen;LI Lan(Department of Gastrointestinal Surgery,Peking Univesity ShenZhen Hospital,Shenzhen 518000,China;不详)

机构地区：[1]天津市天津医院中医外科,天津300221 [2]天津市天津医院中西医骨伤科,天津300221 [3]不详

出　　处：《中国中西医结合外科杂志》2020年第1期62-66,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:探讨减孔(两孔)腹腔镜手术治疗结直肠癌的临床安全性与可行性,发掘减孔腹腔镜手术的优势和适应证。方法:选取行腹腔镜结直肠癌手术患者46例,其中行减孔(两孔)腹腔镜手术16例(减孔组),行传统五孔腹腔镜手术30例(五孔组),收集并比较两组在临床安全性、肿瘤根治效果、术后恢复等方面的差异。结果:两组病例在手术时间、切除肿瘤直径、淋巴结清扫数、术中出血量、中转开腹率、开始排气时间、开始进流食时间、引流管留置时间、住院时间和严重手术并发症时间方面无统计学差异(P>0.05);在切口长度[(4.38±0.92)cm vs.(6.00±2.10)cm],疼痛评分大于3分时间[(0.75±0.68)d vs.(1.77±0.86)d]、开始下床时间[(1.13±1.02)d vs.(1.93±1.01)d]及拔除尿管时间[(2.00±0.73)d vs.(3.93±3.37)d]方面,减孔组优于五孔组(P<0.05)。结论:减孔(两孔)腹腔镜手术是一种安全可行的结直肠肿瘤根治手术方式,相比于传统五孔腹腔镜手术,其在术后恢复方面具有一定优势。Objective Reduced-port laparoscopic surgery is a new surgical technique applied in colorectal cancer treatment in Asian countries.This study aims to evaluate the safety and feasibility of reduced�port laparoscopic surgery(RPLS)compared with conventional multi-port laparoscopic surgery(CMLS)for colorectal cancer.Methods The clinical outcomes of 16 patients who underwent RPLS and 30 patients who underwent CMLS were compared by retrospective case-control study from October 1,2017 to October 1,2018.Results There were no significant differences between RPLS and CMLS regard to surgery duration,tumor diameter,number of lymph nodes dissected,intraoperative blood loss,rate of conversion,exhausting time,fasting time,drainage removal time,discharging time,and postoperative complications(P>0.05).The RPLS group had smaller incisions(4.38 cm vs.6.00 cm,P<0.05),earlier ambulation(1.13 d vs.1.93 d,P<0.05),earlier catheter removal(2.00 d vs.3.93 d,P<0.05)and less pain(0.75 d vs.1.77 d,P<0.05)compared with CMLS group.Conclusion RPLS is a safe and feasible treatment option for patients with colorectal cancer.RPLS may benefit patients by reducing postoperative trauma and drug administration compared with CMLS.

关 键 词：减孔腹腔镜手术 传统五孔腹腔镜手术 结直肠癌 临床安全性 临床可行性 

分 类 号：R735.3[医药卫生—肿瘤]