完全腹腔镜右半结肠切除术中顺蠕动侧侧吻合的有效性及安全性评价  

Efficacy and safety evaluation of Overlap anastomosis in complete laparoscopic right hemicolectomy

作　　者：曹猛 郭杰东 朱灿 许腾 樊瑞智 江涛 宋军 徐溢新 Cao Meng;Guo Jiedong;Zhu Can;Xu Teng;Fan Ruizhi;Jiang Tao;Song Jun;Xu Yixin(Department of Gastrointestinal Surgery,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221004,China;Institute of Digestive Diseases,Xuzhou Medical University,Xuzhou 221004,China)

机构地区：[1]徐州医科大学附属医院胃肠外科,江苏省221004 [2]徐州医科大学消化病研究所,江苏省221004

出　　处：《中华消化病与影像杂志（电子版）》2024年第4期315-319,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：国家自然科学基金(82073133);江苏省卫生健康委医学科研重点A类项目(ZDA2020005);徐州医学领军人才培养项目(XWRCHT20210034)。

摘　　要：目的探讨腹腔镜右半结肠切除术中顺蠕动侧侧吻合(Overlap)的临床应用价值。方法选取2022年5月至2023年5月在徐州医科大学附属医院胃肠外科行腹腔镜右半结肠根治术的结肠癌患者70例进行回顾性研究,32例行全腹腔镜下Overlap吻合(Overlap组),38例行常规体外吻合(对照组),比较两组患者的术中及术后恢复状况、炎症指标、以及围手术期并发症的发生率。结果Overlap组手术切口长度短于对照组[(5.1±0.8)cm和(6.9±1.5)cm,P<0.05],术后首次排气时间早于对照组[(1.7±0.5)d和(2.3±0.6)d,P<0.05],术后首次排便时间早于对照组[(2.6±0.6)d和(2.9±0.6)d,P<0.05];两组的手术时间、术中出血量、淋巴结清扫数目差异均无统计学意义(P>0.05)。术后1 d及4 d复查的白细胞计数、中性粒细胞计数及超敏C反应蛋白均低于对照组(P<0.05);Overlap组和对照组患者术后并发症发生率分别为3.1%和7.9%,差异无统计学意义(P>0.05)。结论完全腹腔镜Overlap吻合在右半结肠切除术中安全可行,更加微创,有利于术后肠道功能快速恢复。Objective To investigate the clinical value of Overlap anastomosis in laparoscopic right hemicolectomy.Methods From May 2022 to May 2023,70 patients who underwent laparoscopic right hemicolectomy in the Department of Gastrointestinal Surgery at Affiliated Hospital of Xuzhou Medical University were selected,32 underwent laparoscopic Overlap anastomosis(Overlap group)and 38 underwent routine extracorporeal anastomosis(control group).The surgical performance,postoperative recovery,inflammatory indicators and perioperative complications of the two groups were compared.Results The surgical incision length in the Overlap group was shorter than that in the control group[(5.1±0.8)cm and(6.9±1.5)cm,P<0.05],and the time of first exhaust and defecation postoperatively was earlier than that in the control group[(1.7±0.5)d and(2.3±0.6)d,P<0.05;(2.6±0.6)d and(2.9±0.6)d,P<0.05].There were no statistically significant differences in surgical time,intraoperative bleeding volume and lymph node dissection count between the two groups(all P>0.05).The leukocyte count,neutrophil count,and high-sensitivity C-reactive protein levels in the Overlap group in the follow-up 1 and 4 days after surgery were lower than those in the control group.The incidence of postoperative complications was 3.1%in the Overlap group and 7.9%in the control group,respectively,with no statistically significant difference(P>0.05).Conclusion Complete laparoscopic right hemicolectomy with Overlap anastomosis is safe,feasible,minimally invasive,and beneficial for rapid postoperative recovery of intestinal function.

关 键 词：结肠癌 完全腹腔镜手术 右半结肠切除术 消化道重建 Overlap吻合 

分 类 号：R735.34[医药卫生—肿瘤]