改良单孔加一孔腹腔镜右半结肠癌根治术的临床效果  

The clinical effect of modified single-incision plus one-port laparoscopic surgery(SILS+1)for radical right hemicolectomy

作　　者：曾之耀 邓海军[2] 刘丙刚 唐兵 屈海波 周湘茂 ZENG Zhiyao;DENG Haijun;LIU Binggang;TANG Bing;QU Haibo;ZHOU Xiangmao(Department of Gastrointestinal Surgery,Lengshuitan Branch,Yongzhou Central Hospital,Yongzhou 425000,Hunan,China;Department of General Surgery,Nanfang Hospital of Southern Medical University,Guangzhou 510515,Guangdong,China)

机构地区：[1]永州市中心医院冷水滩院区胃肠外科,湖南永州425000 [2]南方医科大学南方医院普外科,广东广州510515

出　　处：《中国现代手术学杂志》2024年第4期269-274,共6页Chinese Journal of Modern Operative Surgery

基　　金：国家自然科学基金面上项目(82472887);广东省自然科学基金面上项目(2023A1515010274)。

摘　　要：目的探讨改良单孔加一孔腹腔镜(single-incision plus one-port laparoscopic surgery,SILS+1)右半结肠癌根治术的安全性及有效性。方法采用回顾性病例对照研究。选取2019年1月到2024年6月我院收治的行SILS+1右半结肠癌根治术患者34例。其中对照组23例,行经典的SILS+1右半结肠癌根治术,切口采用3~4 cm绕脐切口+左中腹1.2 cm戳孔;研究组11例,行改良SILS+1右半结肠癌根治术,切口采用3~4 cm下腹部横切口+左中腹1.2 cm戳孔。比较两组的手术时间、出血量、淋巴结清除数量、术后首次肛门排气时间、术后1 d疼痛视觉模拟评分(visual analogue scale,VAS)、术后住院时间等。结果两组出血量、淋巴结清除数量、术后首次肛门排气时间无明显差异(P>0.05);手术时间、术后1 d的VAS及术后住院时间有差异,研究组优于对照组(P<0.05)。结论改良单孔(下腹部横切口)加一孔(左中腹1.2 cm戳孔)腹腔镜右半结肠癌根治手术安全有效,且较绕脐切口手术时间及术后住院时间更短,术后疼痛更轻,手术切口更加美观和隐蔽,值得临床推广应用。Objective To explore the safety and efficacy of the modified single-incision plus one-port laparoscopic surgery(SILS+1)for radical right hemicolectomy for right-sided colon cancer.Methods A retrospective case-control study was adopted.There were 34 patients underwent SILS+1 radical right hemicolectomy for right-sided colon cancer in our hospital from January 2019 to June 2024.Among them,there were 23 cases in the control group who underwent classic SILS+1 radical surgery for right colon cancer,with a 3~4cm incision around the navel and a 1.2cm Trocar puncture hole in the left middle abdomen.And in the study group,11 cases underwent modified SILS+1 radical right hemicolectomy,with a 3~4 cm transverse incision in the lower abdomen and a 1.2cm Trocar puncture hole in the left middle abdomen.Surgical time,the amount of bleeding,number of lymph nodes cleared,the first anal exhaust time after surgery,1-day postoperative visual analogue scale(VAS)of pain,and postoperative hospital stay was compared between the two groups.Results There was no significant difference in the amount of bleeding,number of lymph nodes cleared,nor the time of the first anal exhaust between the two groups(P>0.05).There were differences in surgical time,1-day postoperative VAS,and postoperative hospitalization time,with the study group being superior to the control group(P<0.05).Conclusion It shows safe and effective of the modified single-incision plus one-port laparoscopic surgery(SILS+1)for radical right hemicolectomy for right-sided colon cancer with a lower abdominal incision.Comparing with the classic SILS+1,it has advantages of shorter surgical time,less postoperative pain,and shorter postoperative hospital stay,which is worthy popularization.

关 键 词：结肠肿瘤 右半结肠癌根治术 腹腔镜 单切口加一孔 双切口 手术入路 

分 类 号：R735.35[医药卫生—肿瘤]