腹腔镜右半结肠切除术腹腔内吻合与腹腔外吻合的短期并发症分析  

Analysis of short-term complications of laparoscopic right hemicolectomy with intraperitoneal anastomosis and extraperitoneal anastomosis

作　　者：房雅婷 程志强[2] 翟永华[1] FANG Yating;CHENG Zhiqiang;ZHAI Yonghua(Department of Operating Room,Qilu Hospital of Shandong University,Jinan 250012,China;Department of General Surgery,Qilu Hospital of Shandong University)

机构地区：[1]山东大学齐鲁医院手术室,山东济南250012 [2]山东大学齐鲁医院普通外科

出　　处：《腹腔镜外科杂志》2023年第8期578-582,共5页Journal of Laparoscopic Surgery

摘　　要：目的:对比腹腔镜右半结肠切除术腹腔内吻合与腹腔外吻合短期并发症的发生情况,评估腹腔内吻合是否有助于减少术后并发症的发生。方法:回顾分析2020年5月至2022年12月收治的97例行腹腔镜右半结肠切除术患者的临床资料,其中36例行腹腔内吻合(腔内组),61例行腹腔外吻合(腔外组)。对比分析两组手术时间、术中出血量、淋巴结获取数量、上呼吸道感染、手术切口或戳孔感染、肠梗阻、乳糜漏、吻合口漏、低白蛋白血症、尿潴留、泌尿系统感染、腹腔脓肿、胃瘫、严重电解质紊乱等并发症发生情况。结果:两组患者术前临床资料、手术时间、术中出血量、淋巴结获取数量差异均无统计学意义;腔内组乳糜漏、低白蛋白血症发生率低于腔外组,差异有统计学意义(P<0.05),其他术后短期并发症两组间差异无统计学意义(P>0.05)。结论:腹腔镜右半结肠切除术中腹腔内吻合短期并发症发生率并不高于腹腔外吻合,为结肠癌手术进一步微创化提供了一定的循证医学证据。Objective:To conduct a comparative analysis of the occurrence of short-term complications in laparoscopic right hemicolectomy with intraperitoneal anastomosis and extraperitoneal anastomosis,while also assessing the potential benefits of intraperitoneal anastomosis in reducing postoperative complications.Methods:The present study retrospectively analyzed the clinical data of p atients who underwent laparoscopic right hemicolectomy and were admitted between May 2020 and Dec.2022.97 patients were enrolled,with 36 undergoing intraperitoneal anastomosis(intraperitoneal group)and 61 undergoing extraperitoneal anastomosis(extraperitoneal group).The study compared and analyzed various factors,including operation time,intraoperative blood loss,number of lymph nodes o btained,upper respiratory tract infection,surgical incision or puncture infection,intestinal obstruction,chylous leakage,anastomotic leakage,hypoalbuminemia,urinary retention,urinary system infection,abdominal abscess,gastroparesis,and severe electrolyte distur-bance,in patients who underwent intraperitoneal anastomosis and extraperitoneal anastomosis.Results:No statistically significant diffe-rences were observed in the baseline data,operation time,intraoperative blood loss,and number of lymph nodes obtained between the two groups.The incidence of chylous leakage and hypoalbuminemia was notably lower in the intraperitoneal group compared with the e xtraperitoneal group,and the difference was statistically significant(P<0.05),while no significant disparities were observed in other aspects of short-term complications(P>0.05).Conclusions:The prevalence of short-term complications among individuals undergoing laparoscopic right hemicolectomy with intraperitoneal anastomosis does not surpass that of individuals undergoing extraperitoneal anastomosis,which provides some evidence-based medical evidence for further minimally invasive colon cancer surgery.

关 键 词：右半结肠肿瘤 腹腔镜检查 腹腔内吻合 腹腔外吻合 手术后并发症 对比研究 

分 类 号：R735.35[医药卫生—肿瘤]