3D腹腔镜手术联合加速康复外科在右半结肠癌中的应用  

Application of 3D laparoscopy combined with ERAS in right colon cancer

作　　者：陆峰 王刚[1] 周井荣 张强 邱磊[1] 杨修伟 苗永昌[1] LU Feng;WANG Gang;ZHOU Jingrong;ZHANG Qiang;QIU Lei;YANG Xiuwei;MIAO Yongchang(Department of Gastrointestinal Surgery, the Second People's Hospital of Lianyungang, Lianyungang 222000, China)

机构地区：[1]连云港市第二人民医院胃肠外科,江苏连云港222000

出　　处：《中国肿瘤外科杂志》2021年第1期49-52,共4页Chinese Journal of Surgical Oncology

基　　金：江苏省“六大人才高峰”资助项目(WSW-326);江苏省连云港市科技局资助项目(SH1619)。

摘　　要：目的探讨3D腹腔镜手术联合加速康复外科(ERAS)在右半结肠癌治疗中的应用价值。方法选择2017年2月至2019年12月连云港市第二人民医院胃肠外科收治的68例右半结肠癌患者,根据手术方式的不同,分为3D腹腔镜手术联合ERAS组(36例)和2D腹腔镜手术联合ERAS组(32例),比较两组患者的围手术期情况,包括手术时间、术中出血量、清扫淋巴结总数、术后首次排气时间、术后首次进流食时间、住院时间及并发症情况(Clavien-Dindo分级),从图像质量、深度质量及观看舒适度三个基本维度比较术者对3D和2D腹腔镜视频质量的主观评价。结果3D腹腔镜手术联合ERAS组的手术时间(127.1±22.5)min及术中出血量(78.8±25.6)ml明显少于2D腹腔镜手术联合ERAS组的(146.2±24.8)min和(110.5±28.7)ml,差异有统计学意义(P<0.05);两组患者的清扫淋巴结总数、术后首次排气时间、术后首次进流食时间、住院时间及并发症发生率差异无统计学意义(P>0.05)。术者对两组腹腔镜系统的深度分辨率、深度运动、深度定位、空间变形失真及术中操作感的评分差异有统计学意义(P<0.05),3D腹腔镜优于2D腹腔镜。结论3D腹腔镜手术联合ERAS干预治疗右半结肠癌安全可行,且3D腹腔镜手术能够提供良好的三维视野,增强立体感和操作感,能更精确地判断组织距离与层次,缩短手术时间,减少术中出血,值得临床进一步推广应用。Objective To explore the application value of 3D laparoscopy combined with ERAS in right colon cancer surgery.Methods From February 2017 to December 2019,68 patients with right colon cancer were admitted to the Gastrointestinal Surgery Department of the Second People's Hospital of Lianyungang City.According to different surgical methods,they were divided into 3D laparoscopic surgery combined with ERAS group(36 cases)and 2D Laparoscopy combined with ERAS group(32 cases),compared the perioperative conditions of the two groups of patients,including operation time,intraoperative blood loss,total number of lymph nodes removed,postoperative first exhaust time,postoperative first time to eat fluids,hospitalization time and Complications(Clavien-Dindo classification)compare the subjective evaluation of the video quality by the surgeon from the three basic dimensions of image quality,depth quality and viewing comfort.Results The operation time of 3D laparoscopic surgery combined with ERAS group([127.1±22.5]min vs.[146.2±24.8]min)and intraoperative blood loss([78.8±25.6]ml vs.[110.5±28.7]ml)were significantly less than the difference between 2D laparoscopic surgery combined with ERAS group was statistically significant(P<0.05);there were no differences in the total number of lymph nodes dissected,the time of first exhaustion after operation,the time of first fluid intake after hospitalization,the length of hospitalization and complications of the two groups of patients academic significance(P>0.05).The surgeon had statistically significant differences in the scores of the depth resolution,depth motion,depth positioning,spatial deformation and distortion and intraoperative operability of the two groups of endoscopic systems(P<0.05).Conclusions 3D laparoscopic surgery for right colon cancer combined with ERAS intervention is safe and feasible,and 3D laparoscopic surgery can provide a good three-dimensional field of vision,enhance stereoscopic impression and sense of operation,so as to more accurately judge the tissue dis

关 键 词：结肠肿瘤 3D腹腔镜 加速康复外科 主观感受 术后恢复 

分 类 号：R73[医药卫生—肿瘤]