全腹腔镜与腹腔镜辅助右半结肠切除术治疗右半结肠癌临床研究  

Clinical investigation of laparoscopic and laparoscopic-assisted right hemicolectomy for right hemicolon carcinoma

作　　者：潘雪凯 吴凯 高官壮 陈涛 李炫飞 方效昌 冯茂辉[2] 曹翔 Pan Xuekai;Wu Kai;Gao Guanzhuang;Chen Tao;Li Xuanfei;Fang Xiaochang;Feng Maohui;Cao Xiang(Department of Gastrointestinal Surgery,the Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University,Changzhou 213000,China;Department of Gastrointestinal Surgery,Zhongnan Hospital of Wuhan University,Clinical Medical Research Center of Peritoneal Cancer of Wuhan,Hubei Province Cancer Clinical Study Center,Zhongnan Hospital of Wuhan University,Hubei Key Laboratory of Tumor Biological Behaviors,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]南京医科大学附属常州第二人民医院胃肠外科,常州213000 [2]武汉大学中南医院胃肠外科,武汉市腹膜癌临床医学研究中心,湖北省肿瘤医学临床研究中心,肿瘤生物学行为湖北省重点实验室,武汉430071

出　　处：《中华实验外科杂志》2024年第2期336-339,共4页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目(82070302、81902018);武汉市腹膜癌临床医学研究中心资助项目(2015060911020462);吴阶平医学基金会临床科研专项资助项目(320.6750.2023-11-9、320.6750.2023-11-2);武汉大学中南医院科技创新培育基金资助项目(CXPY2022055);武汉大学中南医院医学科技创新平台建设支撑项目资助项目(PTXM2023004、PTXM2023020)。

摘　　要：目的比较全腹腔镜右半结肠切除与腹腔镜辅助右半结肠切除治疗右半结肠癌的临床效果。方法分析常州市第二人民医院2020年10月至2023年10月收治的82例施行腹腔镜下右半结肠切除术患者资料, 全腹腔镜组和腹腔镜辅助组各41例。使用t检验、χ^(2)检验或确切概率法对比分析全腹腔镜组及腹腔镜辅助组的术中指标(手术时间、淋巴结清扫数目)及术后指标(术后排气时间、住院时长、辅助切口长度、术后疼痛程度、并发症例数), 两组比较采用t检验。结果全腹腔镜组手术时间[(152.76±8.84) min比(151.59±9.31) min, t=0.086, P>0.05]、淋巴结清扫个数[(21.27±1.52)比(21.65±1.41), t=0.065, P>0.05]、并发症发生率[19.5%(7/41)比17.1%(8/41), χ^(2)=0.085, P>0.05]与腹腔镜辅助组基本相似, 差异均无统计学意义。全腹腔镜组术后排气时间明显早于腹腔镜辅助组[(2.00±0.24) d比(3.14±0.37) d, t=11.209, P<0.01];住院时间明显短于腹腔镜辅助组[(6.03±0.24) d比(7.40±0.35) d, t=12.976, P<0.05];术后疼痛程度明显低于腹腔镜辅助组[(2.49±0.51)分比(4.32±0.47)分, t=6.101, P<0.05];辅助切口长度明显短于腹腔镜辅助组[(3.91±0.25) cm比(5.37±0.49) cm, t=16.055, P<0.01], 差异均有统计学意义。结论右半结肠癌患者行全腹腔镜右半结肠切除可有效减小辅助切口长度, 减轻术后疼痛程度, 缩短患者住院时长, 促进术后康复, 更符合快速康复理念, 疗效显著。Objective To compare the clinical effects of total laparoscopic right hemicolectomy and laparoscopic assisted right hemicolectomy in the treatment of right colon cancer.Methods The data of 82 patients undergoing laparoscopic right hemicolectomy treated in Changzhou No.2 People’s Hospital from October 2020 to October 2023 were retrospectively analyzed,including 41 cases in the total laparoscopic group and 41 cases in the laparoscopic-assisted group.Intraoperative indexes(operation time,number of dissected lymph nodes)and postoperative indexes(postoperative exhaust time,length of hospital stay,length of auxiliary incision,postoperative pain degree,incidence of complications)were compared between the total laparoscopic group and the laparoscopic-assisted group using t-test,chi square analysis or Fisher’s exact test.Results The operative time[(152.76±8.84)min vs.(151.59±9.31)min,t=0.086,P>0.05],the number of dissected lymph nodes[(21.27±1.52)vs.(21.65±1.41),t=0.065,P>0.05]and the incidence of complications[19.5%(7/41)vs.17.1%(8/41),χ^(2)=0.085,P>0.05]in the total laparoscopic group were basically similar to those in the laparoscopic-assisted group.The postoperative exhaust time in the total laparoscopic group was significantly earlier than that in the laparoscopic-assisted group[(2.00±0.24)d vs.(3.14±0.37)d,t=11.209,P<0.01].The hospital stay in the total laparoscopic group was significantly shorter than that in the laparoscopic-assisted group[(6.03±0.24)days vs.(7.40±0.35)days,t=12.976,P<0.05].The postoperative pain degree was significantly lower in the total laparoscopic group than that in the laparoscopic-assisted group[(2.49±0.51)points vs.(4.32±0.47)points,t=6.101,P<0.05].The auxiliary incision length in the total laparoscopic group was significantly shorter than that in the laparoscopic-assisted group[(3.91±0.25)cm vs.(5.37±0.49)cm,t=16.055,P<0.01].Conclusion Total laparoscopic resection of the right half colon in patients with right half colon cancer can effectively reduce the length of the aux

关 键 词：全腹腔镜 腹腔镜辅助 右半结肠切除 

分 类 号：R735.35[医药卫生—肿瘤]