改良入路在手助腹腔镜结肠癌手术中的应用  

Application of Improved Approach in Hand-assisted Laparoscopic Surgery for Colonic Cancer

作　　者：张丽华 任镜清 杨小红[3] 张涵朔 钟其光 刘少杰 ZHANG Lihua;REN Jingqing;YANG Xiaohong;ZHANG Hansu;ZHONG Qiguang;LIU Shaojie(Graduate School of Guizhou Medical University,Guiyang 550004,China;Department of General Surgery,Guangzhou Red Cross Hospital Affiliated to Jinan University,Guangzhou 510220,China;Institute of Trauma Surgery,Guangzhou Red Cross Hospital Affiliated to Jinan University,Guangzhou 510220,China)

机构地区：[1]贵州医科大学研究生院,贵阳550004 [2]暨南大学附属广州红十字会医院普外科,广州510220 [3]暨南大学附属广州红十字会医院创伤外科研究所,广州510220

出　　处：《医学综述》2022年第6期1224-1228,共5页Medical Recapitulate

基　　金：广东省中医药局科研项目(20201264)。

摘　　要：目的探究改良入路白蝶手助装置在手助腹腔镜(HALS)结肠癌根治术中的安全性与可行性。方法选取2018年6月至2020年6月暨南大学附属广州红十字会医院普外科收治的行HALS结肠癌根治术的202例结肠癌患者,依据手助装置不同分为蓝蝶组(101例)和白蝶组(101例),比较两组术中和术后相关指标、并发症发生情况。结果白蝶组手术时间、住院总费用均少于蓝蝶组[(196.3±43.2)min比(212.5±43.1)min、(81161±13027)元比(85809±12944)元],但术中休息间隔时间长于蓝蝶组[(44.9±7.8)min比(36.7±4.0)min](P<0.05或P<0.01)。两组术中出血量、气腹压、淋巴结清扫个数、术后首次排气时间、术后住院时间比较差异无统计学意义(P>0.05)。白蝶组辅助手操作前后血氧饱和度差值低于蓝蝶组[(2.3±1.3)比(5.4±1.3)](t=6.046,P<0.001)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论改良入路白蝶手助装置在HALS结肠癌治疗中的安全性与可行性均较好,可提供更舒适的辅助手操作体验、缩短手术时间、降低手术治疗费用。Objective To investigate the safety and feasibility of the improved approach of white disc in hand-assisted laparoscopic radical resection(HALS)of colon cancer.Methods A total of 202 patients undergoing colon cancer surgery with HALS in Guangzhou Red Cross Hospital affiliated to Jinan University from Jun.2018 to Jun.2020 were included,and divided into a white disc group(101 cases)and a blue disc(Lap disc)group(101 cases)according to the hand port.The two groups were compared with each other in terms of intraoperative and postoperative indicators,and complications.Results The operative time and total hospital costs in the white disc group were less than those in the blue disc group[(196.3±43.2)min vs(212.5±43.1)min,(81161±13027)yuan vs(85809±12944)yuan],but the rest intervals was longer[(44.9±7.8)min vs(36.7±4.0)min](P<0.05 or P<0.01).There was no significant difference in intraoperative blood loss,intraoperative average pneumoperitoneum pressure,number of lymph nodes dissected,time of first postoperative exhaust,and hospital stay after operation(P>0.05).The difference of blood oxygen saturation before and after hand port operation of the white disc group was lower than that of the blue disc group[(2.3±1.3)vs(5.4±1.3)](t=6.046,P<0.001).The difference in complication incidence between the two groups had no statistical significance(P>0.05).Conclusion The improved approach has good safety and feasibility in the HALS treatment of colon cancer,which can provide more comfortable manual operation experience,shorten the operation time and reduce the cost of surgical treatment.

关 键 词：结肠癌 手助腹腔镜手术 改良入路 

分 类 号：R735.35[医药卫生—肿瘤]