进展期右半结肠癌腹腔镜D3根治术手术时长对术后疗效的影响  

Effect of operative duration on postoperative efficacy of laparoscopic D3 radical resection for advanced right colon cancer

作　　者：黄海鹏 熊文俊 郑燕生 罗立杰 李金 崔梓铭 王伟[1] Huang Haipeng;Xiong Wenjun;Zheng Yansheng;Luo Lijie;Li Jin;Cui Ziming;Wang Wei(Department of Gastrointestinal Surgery,the Second Affiliated Hospital,Guangzhou University of Chinese Medicine(Guangdong Provincial Hospital of Chinese Medicine),Guangdong 510030,China)

机构地区：[1]广州中医药大学第二附属医院(广东省中医院)胃肠外科,广州510030

出　　处：《中华解剖与临床杂志》2023年第1期56-60,共5页Chinese Journal of Anatomy and Clinics

基　　金：广东省中医院临床研究专项(YN1010911)。

摘　　要：目的探讨进展期右半结肠癌患者行腹腔镜D3根治术的手术时长对术后临床疗效的影响。方法横断面研究。纳入2018年1月—2020年8月广东省中医院行腹腔镜D3根治术治疗的94例进展期右半结肠癌患者,其中男46例、女48例,年龄16~93(64.2±16.1)岁,TNM分期Ⅱ45例、Ⅲ期49例。患者均行腹腔镜右半结肠癌D3根治术,手术时间100~327(198.9±53.4)min。根据患者手术时间,分别选择在手术时长20百分位数(152 min)、40百分位数(180 min)、60百分位数(205 min)和80百分位数(237 min)4个时间节点,分别分为≤该节点时长和>该节点时长2组。比较不同时间节点2组患者临床基线资料和围手术期指标(包括术中出血量、术后首次排气时间、术后住院时间,以及术后并发症发生情况)。结果94例患者均顺利完成手术,无中转开腹者,术中、住院期间无一例死亡。94例患者术中出血量10~200 mL,术后首次排气时间1~5 d,术后住院时间3~21 d。术后并发呼吸道感染3例,切口感染4例,吻合口漏2例,腹腔积液4例,肠梗阻2例。不同时间节点2组患者性别、年龄、肿瘤大小和BMI等临床基线资料比较,差异均无统计学意义(P值均>0.05);60百分位数、80百分位数2个时间节点患者的肿瘤分期组间比较差异均有统计学意义(χ^(2)=6.79、6.86,P值均<0.05)。围手术期指标比较,60百分位数2组患者的术后住院时间和80百分位数2组患者的首次排气时间、术后住院时间、术后总并发症发生率差异均有统计学意义(P值均<0.05),其他各组的各项观察指标差异均无统计学意义(P值均>0.05)。结论进展期右半结肠癌患者行腹腔镜D3根治术治疗,随着手术时间的延长,患者术后恢复时间增加,并发症发生率升高。Objective To study the effect of the operative duration on postoperative clinical efficacy of laparoscopic D3 radical resection for advanced right colon cancer.Methods This study is a cross-sectional study.Ninety-four patients with advanced right colon cancer in Guangdong Hospital of Traditional Chinese Medicine from January 2018 to August 2020 were included.The patients comprised 46 males and 48 females,including 45 and 49 patients in stagesⅡandⅢ,respectively,aged 16-93(64.2±16.1)years.All patients successfully underwent laparoscopy-assisted D3 radical resection of right colon cancer.The operation duration was in the range of 100-327(198.9±53.4)min.Four time nodes based on the length of operation time of the patients,namely,the 20th(152 min),40th(180 min),60th(205 min),and 80th percentiles(237 min),were divided into two groups≤the duration of the node and>the duration of the node.The clinical baseline data of patients in each group were compared,and perioperative indicators,including intraoperative blood loss,first postoperative exhaust time,postoperative hospital stay,and postoperative complications,were observed.Results The operation was successfully performed in all patients,no operation was converted to open surgery,and no intraoperative death occurred during hospitalization.The intraoperative blood loss was 10-200 mL,the first exhaust time was 1-5 days,and the postoperative hospital stay was 3-21 days.Postoperative complications included respiratory tract infection in three cases,incision infection in four cases,anastomotic leakage in two cases,abdominal effusion in four cases,and intestinal obstruction in two cases.Comparison of clinical baseline data showed no significant differences in gender,age,tumor size,and BMI among all groups(all P values>0.05).Significant differences in tumor stage were found in the 60th and 80th percentile arrays(χ^(2)=6.79,6.86;all P values<0.05).Comparison of perioperative indicators showed significant differences in postoperative hospital stay in the 60th percentile a

关 键 词：结肠肿瘤 右半结肠切除术 腹腔镜D3根治术 手术时长 术后疗效 

分 类 号：R735.35[医药卫生—肿瘤]