经尾侧联合中线入路应用于腹腔镜右半结肠癌D3根治术的效果  

Effect of Caudal Combined Midline Approach in Laparoscopic D3 Radical Resection of Right Colon Cancer

作　　者：高桂明 GAOGuiming(Shaowu Municipal Hospital,Shaowu 354000,China)

机构地区：[1]邵武市立医院,福建邵武354000

出　　处：《中外医学研究》2024年第25期127-131,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨经尾侧联合中线入路应用于腹腔镜右半结肠癌D3根治术的效果。方法:选取2023年10月—2024年3月邵武市立医院收治的82例拟使用腹腔镜右半结肠癌D3根治术治疗的结肠癌患者作为研究对象,将患者随机分为对照组(n=41)与观察组(n=41)。观察组使用经尾侧联合中线手术入路,对照组使用常规中线手术入路,两组术后均观察1周。比较两组手术指标、术后恢复情况、肿瘤标志物[糖类抗原199(CA199)、癌胚抗原(CEA)]水平及术后1周内并发症发生情况。结果:两组术中淋巴结清扫数目、术后首次排便时间比较,差异无统计学意义(P>0.05);与对照组相比,观察组手术时长、术后首次排气时间、拔除引流管时间较短,术中出血量较少,差异有统计学意义(P<0.05)。术后1周,两组CEA、CA199水平均下降,且与对照组相比,观察组较低,差异有统计学意义(P<0.05)。两组术后1周内并发症发生率比较,差异无统计学意义(P>0.05)。结论:经尾侧联合中线入路应用于腹腔镜右半结肠癌D3根治术,可有效减少术中出血量,缩短手术时间,同时加快术后胃肠道功能恢复,降低肿瘤标志物水平,且安全性与中线入路相当。Objective:To investigate the effect of effect of caudal combined midline approach in laparoscopic D3 radical resection of right colon cancer.Method:A total of 82 patients with colon cancer who treated with laparoscopic D3 radical resection of right colon cancer in Shaowu Municipal Hospital from October 2023 to March 2024 were selected as the study objects,the patients were randomly divided into the control group(n=41)and the observation group(n=41).The observation group was used the caudal combined midline surgical approach,and the control group was used the conventional midline surgical approach,two groups were observed for 1 week after surgery.The surgical indicators,postoperative recovery,tumor markers[carbohydrate antigen 199(CA199),carcinoembryonic antigen(CEA)]levels and complications within 1 week after operation were compared between two groups.Result:There were no significant differences in the number of lymph node dissection and the first defecation time between two groups(P>0.05);compared with the control group,the observation group had shorter operation time,first postoperative exhaust time and drainage tube removal time,and less amount of intraoperative blood loss,the differences were statistically significant(P<0.05).At 1 week after operation,the levels of CEA and CA199 in two groups were decreased,and compared with the control group,the observation group were lower,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications within 1 week after operation between two groups(P>0.05).Conclusion:The application of the caudal combined midline approach in laparoscopic D3 radical resection of right colon cancer can effectively reduce the amount of intraoperative blood loss,shorten the operation time,accelerate the recovery of postoperative gastrointestinal function,reduce the level of tumor markers,and the safety is comparable to that of the midline approach.

关 键 词：结肠肿瘤 腹腔镜右半结肠癌D3 根治术 手术入路 

分 类 号：R735.35[医药卫生—肿瘤]