预切口在有腹部手术史患者行腹腔镜下结直肠癌根治术中的应用研究  

Application of pre-incision in laparoscopic radical resection of colorectal cancer inpatients with previous history of abdominal surgery

作　　者：邱雨豪 张大洪 陈贞舟 皮峰 魏正强[1] QIU Yuhao;ZHANG Dahong;CHEN Zhenzhou;PI Feng;WEI Zhengqiang(Department of Gastrointestinal Surgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院胃肠外科,重庆400016

出　　处：《重庆医学》2023年第24期3765-3769,共5页Chongqing medicine

基　　金：重庆市卫生健康委项目(2019ZX003)。

摘　　要：目的探讨预切口在有腹部手术史患者行腹腔镜下结直肠癌根治术中的应用价值。方法收集141例有腹部手术史并行腹腔镜下结直肠癌根治术患者的临床资料,其中预切口组71例、传统组70例。预切口组在建立气腹之前,通过选择合适的位置提前进腹并用作辅助切口,行结直肠癌根治术;传统组采用常规结直肠癌根治术步骤,术中完成辅助切口。比较两组患者手术相关指标、切口相关指标和远期并发症发生情况。结果两组患者在出血量、术后首次排气时间、术后首次排便时间、住院时间、切口愈合时间、切口视觉模拟量表(VAS)评分,术后并发症、切口感染、切口脂肪液化、切口血肿及远期并发症发生率比较差异均无统计学意义(P>0.05)。预切口组患者术中穿刺戳卡副损伤发生率低于传统组,差异有统计学意义(P=0.028)。结论预切口能提高有腹部手术史患者行腹腔镜下结直肠癌根治术的可操作性和安全性。Objective To investigate the application value of pre-incision in laparoscopic radical resection of colorectal cancer in patients with a history of abdominal surgery.Methods The clinical data of 141 patients who had a history of abdominal surgery and underwent laparoscopic radical resection of colorectal cancer were collected,including 71 cases in the pre-incision group and 70 cases in the traditional group.The pre-incision group underwent radical resection of colorectal cancer by selecting the appropriate position to enter the abdomen in advance and using it as an auxiliary incision before establishing the pneumoperitoneum.The traditional group was treated with conventional radical resection of colorectal cancer,and auxiliary incision was completed during the operation.The operation related indexes,incision related complications and long-term complications were compared between the two groups.Results There was no significant difference between the two groups in the amount of bleeding,postoperative first exhaust time,postoperative first defecation time,hospitalization time,incision healing time,incision visual analogue scale(VAS) score,postoperative complications,incision infection,incision fat liquefaction,incision hematoma The incidence of incisional hernia and long-term complications were not statistically significant(P>0.05).The incidence of puncture card injury in the pre-incision group was lower than that in the traditional group,and the difference was statistically significant(P=0.028).Conclusion Pre-incision can improve the operability and safety of laparoscopic radical resection of colorectal cancer in patients with a history of abdominal surgery.

关 键 词：腹腔镜手术 腹腔镜辅助结直肠癌根治术 腹部手术史 预切口 辅助切口 

分 类 号：R656.9[医药卫生—外科学]