全腹腔镜下肠吻合与辅助切口肠吻合在右半结肠癌根治术中的临床疗效对比  

Comparison of clinical efficacy between totally laparoscopic colon anastomosis and laparoscopic-assisted colon anastomosis in radical surgery for right-sided colon cancer

作　　者：刘海滨[1] 张国超[1] 周雷[1] 宋新 杨华 LIU Haibin;ZHANG Guochao;ZHOU Lei(Department of Gastrointestinal Surgery,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院普外科-胃肠外科,北京100029

出　　处：《腹腔镜外科杂志》2024年第6期420-424,共5页Journal of Laparoscopic Surgery

摘　　要：目的:对比分析全腹腔镜下肠吻合与辅助切口肠吻合在腹腔镜右半结肠癌根治术中的临床疗效。方法:回顾分析2017年1月至2022年10月收治的拟手术治疗的右半结肠癌患者的临床资料,根据消化道重建方式分为观察组(全腹腔镜下肠吻合)与对照组(辅助切口肠吻合)。收集两组患者临床资料(年龄、性别、体质指数)、手术时间、术中出血量、手术切口长度、淋巴结清扫数量、术后疼痛评分、术后首次排气时间与排便时间、术后下床活动时间、切口愈合时间、住院时间及术后并发症发生率。结果:共纳入152例患者,其中观察组74例,对照组78例。与对照组相比,观察组术后疼痛评分低,手术切口、术后首次排气时间、术后首次排便时间、术后下床行走时间、切口愈合时间短,差异有统计学意义(P<0.05);两组手术时间、淋巴结清扫数量、术中出血量及术后并发症发生率差异无统计学意义(P>0.05)。结论:与腹腔镜辅助切口肠吻合术相比,全腹腔镜肠吻合的临床疗效更佳,值得临床推广。Objective:To compare and analyze the clinical efficacy of totally laparoscopic colon anastomosis and laparoscopic-assisted colon anastomosis in radical surgery for the right hemicolon cancer,aiming to provide evidence-based medicine for the develop-ment of laparoscopic techniques.Methods:Patients with right hemicolon cancer who underwent surgical treatment from Jan.2017 to Oct.2022 were retrospectively reviewed.According to the method of digestive tract reconstruction,they were divided into two groups:totally laparoscopic colon anastomosis group(observation group)and laparoscopic-assisted colon anastomosis group(control group).Demographic data(age,sex,body mass index),operative time,intraoperative blood loss,length of surgical incision,number of lymph nodes harvested,postoperative pain visual analogue scale score,time to first flatus,time to first defecation,time to ambulation,incision healing time,hospital stay,and postoperative complication rate were collected in both groups.Results:A total of 152 patients were included according to the inclusion and exclusion criteria,with 74 patients in the observation group and 78 patients in the control group.The length of surgical incision and postoperative pain score were significantly lower in the observation group compared with the control group(P<0.05).The time to first flatus,time to first defecation,time to ambulation,and incision healing time were all shorter in the observation group compared to the control group(P<0.05).There was no significant difference in operative time,number of lymph nodes dissection,intraoperative blood loss,and postoperative complication rate between the observation group and the control group(P>0.05).Conclusions:Compared with laparoscopic-assisted colon anastomosis,totally laparoscopic colon anastomosis achieves better clinical outcomes in radical surgery for the right hemicolon cancer and is worthy of clinical promotion.

关 键 词：结肠肿瘤 右半结肠癌根治术 腹腔镜检查 肠吻合 疗效比较研究 

分 类 号：R735.35[医药卫生—肿瘤]