3D腹腔镜右半结肠癌根治术对内脏型肥胖患者淋巴结清扫的应用价值  

Application value of 3D laparoscopic radical surgery of right colon cancer for lymph node dissection in obese patients

作　　者：陆雄[1] 陈海伟[1] 刘益民[1] 杨洋[1] Lu Xiong;Chen Haiwei;Liu Yiming;Yang Yang(Department of Pancreatic and Spleen Surgery,,Baoji People’s Hospital General Liver,Biliary,Baoji Shanxi Province 721000,China)

机构地区：[1]宝鸡市人民医院普外肝胆胰脾外科,陕西宝鸡721000

出　　处：《中华普外科手术学杂志（电子版）》2022年第3期311-314,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：陕西省重点研发计划项目(2019SF-053)。

摘　　要：目的研究三维(3D)腹腔镜右半结肠癌根治术对内脏型肥胖患者淋巴结清扫的应用价值。方法回顾性分析2017年1月至2020年12月112例腹腔镜下行右半结肠癌全结肠系膜切除术内脏型肥胖患者的临床资料。根据手术使用腹腔镜系统不同将其分为3D组(n=47例)和2D组(n=65例)。使用SPSS 24.0软件进行数据分析,围手术期指标、血清指标等计量资料采用)表示,组间比较采用独立样本t检验;术后并发症等计数资料采用[n(%)]表示,组间比较采用X^(2)检验。P<0.05差异有统计学意义。结果3D组患者手术时间、术中失血量、术后排气时间及住院时间均较2D组更少,淋巴结清扫数目更多,两组间差异均有统计学意义(P<0.05);两组间住院费用及淋巴结检出阳性率比较,差异无统计学意义(P>0.05)。3D组患者术后并发症发生率为14.9%,2D组为18.5%,两组间差异无统计学意义(P>0.05)。两组手术成像质量、视觉疲劳及操控协调方面,差异无统计学意义(P>0.05);在空间定向及视角自由度的比较中,3D组评分较2D组高,差异有统计学意义(P<0.05)。结论内脏型肥胖患者右半结肠癌根治术应用3D腹腔镜技术可缩短手术时间,减少术中出血,增加淋巴结清扫数目,更利于患者术后早期恢复。Objective To study the application value of 3D laparoscopic radical surgery of right colon cancer for lymph node dissection in obese patients.Methods The clinical data of 112 patients with visceral obesity undergoing laparoscopic total mesenteric resection of right colon cancer from January 2017 to December 2020 were retrospectively analyzed.The patients were divided into 3D group(n=Al cases)and 2D group(n=65 cases)according to different laparoscopic systems.SPSS 24.0 software was used for data analysis.Perioperative indicators,serum indicators and other measurement data were expressed by(s±x).Independent sample X^(2) test was used for comparison between groups.Postoperative complications were expressed by[n(%)],and X^(2)test was used for comparison between groups.P<0.05 was statistically significant.Results Compared with 2D group,3D group had less operation time,intraoperative blood loss,postoperative exhaust time and hospital stay,and more lymph node dissection,with statistical significance(P<0.05);There was no significant difference between the two groups in hospitalization cost and positive rate of lymph node detection(P>0.05).The incidence of complications was 14.9%in the 3D group and 18.5%in the 2D group,with no significant difference between the two groups(P>0.05).There was no significant difference in imaging quality?visual fatigue and manipulation coordination between the two groups(P>0.05);in the comparison of spatial orientation and visual angle freedom,the score of 3D group was higher than 2D group,and the difference was statistically significant(P<0.05).Conclusion The application of 3D laparoscopic technology in radical resection of right colon cancer in patients with visceral obesity can shorten the operation time,reduce intraoperative bleeding,increase the number of lymph node dissection,and facilitate the early postoperative recovery of patients.

关 键 词：结肠肿瘤 肥胖 腹腔镜 成像 三维 淋巴结切除术 

分 类 号：R73[医药卫生—肿瘤]