全腹腔镜下改良三角吻合技术治疗乙状结肠癌的疗效及预后  

The effect and prognosis of improved laparoscopic triangular anastomosis in the treatment of sigmoid colon cancer

作　　者：谢就坤 徐一劲[1] 汤献忠[1] 姚艳芳[2] XIE Jiukun;XU Yijin;TANG Xianzhong;YAO Yanfang(Department of Anoenterology,Dongguan Peoples Hospi-tal,Dongguan,Guangdong 523000,China;Department of Health Management Centre,Dongguan Peoples Hospi-tal,Dongguan,Guangdong 523000,China)

机构地区：[1]东莞市人民医院肛肠科,广东东莞523000 [2]东莞市人民医院健康管理中心,广东东莞523000

出　　处：《安徽医药》2021年第5期910-913,共4页Anhui Medical and Pharmaceutical Journal

基　　金：东莞市科技发展项目(201650715001399)。

摘　　要：目的探讨全腹腔镜下改良三角吻合技术治疗乙状结肠癌的疗效及预后,为选择临床治疗方案提供参考。方法选取2018年9月至2019年7月东莞市人民医院接受腹腔镜乙状结肠癌根治术治疗的结肠癌病人98例。根据简单随机分组法分成观察组48例与对照组50例。对照组采用腹腔镜辅助小切口重建治疗,观察组采用全腹腔镜下改良三角吻合技术治疗。随访6个月,比较两组手术指标、手术效果、术后数字疼痛强度量表(NRS)评分、并发症及复发转移情况。结果观察组总手术时间、消化道重建时间、肛门排气时间[(147.37±31.64)min、(32.25±9.03)min、(2.93±0.85)d]均短于对照组[(163.92±34.85)min、(41.16±11.89)min、(3.70±1.02)d],差异有统计学意义(P<0.05);观察组术中出血量、下地活动时间、住院时间与对照组比较,差异无统计学意义(P>0.05)。观察组淋巴结清扫数、肠管切除长度、肿瘤大小、肿瘤分期与对照组比较,差异无统计学意义(P>0.05)。观察组病人术后第1天、第3天NRS评分[(3.75±0.72)分、(2.81±0.65)分]明显低于对照组[(4.38±0.83)分、(3.46±0.74)分],差异有统计学意义(P<0.05);两组病人术后第5天NRS评分比较,差异无统计学意义(P>0.05)。观察组病人围术期并发率为10.42%,低于对照组病人的12.00%,但差异无统计学意义(P>0.05)。随访6个月,两组病人均未出现肿瘤局部复发或远处转移情况。结论全腹腔镜下改良三角吻合技术治疗乙状结肠癌的疗效显著,且可缩短手术时间,促进肠道康复,减轻术后疼痛,具有临床推广应用价值。Objective To explore the curative effect and prognosis of the improved triangular anastomosis technique under total laparoscopic surgery in the treatment of sigmoid colon cancer,so as to provide reference for the selection of clinical treatment options.Methods A total of 98 patients who underwent laparoscopic radical sigmoid carcinoma treatment from September 2018 to July 2019 were selected as the research subjects.According to simple random grouping method,48 cases were divided into observation group and 50 cases in control group.The control group was treated with laparoscopic assisted small incision reconstruction,and the observation group was treated with modified laminoscopic anastomosis.Followed up for 6 months,the surgical indexes,surgical effects,postoperative VAS pain scores,complications,and recurrence and metastasis were compared between the two groups of patients.Results The total operation time,digestive tract reconstruction,and anal exhaust time[(147.37±31.64)min,(32.25±9.03)min,(2.93±0.85)d]in the observation group were shorter than those in the control group(163.92±34.85)min,(41.16±11.89)min,(3.70±1.02)d,the difference was statistically significant(P<0.05);the intraoperative blood loss,ground activity time,and length of hospital stay of the observation group were not significantly different from those of the control group(P>0.05).Compared with the control group,the number of lymph node dissections,intestinal resection length,tumor size,and tumor stage in the observation group were not statistically significant(P>0.05).The VAS pain scores[(3.75±0.72)points,(2.81±0.65)points]of patients in the observation group on the first and third postoperative days were lower than those in the control group[(4.38±0.83)points,(3.46±0.74)points],and the differences were statistically significant(P<0.05);there was no significant difference in VAS pain scores between the two groups on the 5th day after surgery(P>0.05).The perioperative rate in the observation group was 10.42%,which was significantly lower t

关 键 词：乙状结肠肿瘤 腹腔镜 改良三角吻合 消化道重建 疗效 并发症 

分 类 号：R735.35[医药卫生—肿瘤]