尾侧联合中线入路与中线入路用于腹腔镜右半结肠癌D3根治术的效果对比  

Comparative study of effect of caudal combined with midline approach versus midline approach in laparoscopic D3 radical resection of right hemicolon cancer

作　　者：陈林涛[1] 周学伟[1] 刘长生[1] 张一帆[1] Chen Lintao;Zhou Xuewei;Liu Changsheng;Zhang Yifan(Department of Gastrointestinal Surgery,Nanyang Second People’s Hospital,Nanyang 473012,China)

机构地区：[1]南阳市第二人民医院胃肠外科,南阳473012

出　　处：《中国实用医刊》2024年第22期12-15,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较尾侧联合中线入路与中线入路用于腹腔镜右半结肠癌(RCC)D3根治术的效果。方法回归性抽取2022年6月至2023年12月南阳市第二人民医院收治的行腹腔镜RCC D3根治术患者62例,按随机数字表法分为中线组和联合组,每组31例。中线组采用中线入路,联合组采用尾侧联合中线入路。对比两组围术期指标及术后恢复情况、胃肠激素[胃动素(MTL)、胃泌素(GAS)]、肿瘤标志物[糖类抗原125(CA125)、癌胚抗原(CEA)]及并发症发生率。结果联合组手术时间、术后首次排气时间、术后首次排便时间均短于中线组(P均<0.05)。术后14 d,联合组MTL、GAS水平高于中线组(P<0.05);术后14 d,联合组CA125、CEA水平低于中线组(P<0.05)。联合组并发症发生率(12.90%,4/31)与中线组(6.45%,2/31)比较差异未见统计学意义(P>0.05)。结论在腹腔镜RCC D3根治术中使用尾侧联合中线入路的效果更好,能缩短术后排气、排便时间,提高胃肠激素指标,促进机体恢复,并能降低CA125、CEA水平,安全性良好。ObjectiveTo compare the effects of the caudal combined with midline approach and midline approach in laparoscopic D3 radical resection of right hemicolon cancer(RCC).MethodsA total of 62 patients who underwent laparoscopic D3 radical resection of RCC from June 2022 to December 2023 in Nanyang Second People’s Hospital were selected regressively.And they were divided into the midline group and the combined group according to the random number table method,with 31 cases in each group.The midline group was treated by surgery through midline approach,and the combined group was treated by surgery through caudal combined with midline approach.The perioperative indicators,postoperative recovery,gastrointestinal hormones,including motilin(MTL)and gastrin(GAS),tumor markers including carbohydrate antigen 125(CA125)and carcinoembryonic antigen(CEA),and the incidence of complications were compared between the two groups.ResultsThe operation duration,the first postoperative exhaust time and the first postoperative defecation time in the combined group were shorter than those in the midline group(all P<0.05).The levels of MTL and GAS in the combined group were higher than those in the midline group 14 days after treatment(P<0.05).The levels of CA125 and CEA in the combined group were lower than those in the midline group 14 days after treatment(P<0.05).There was no significant difference in the incidence of complications between the combined group(12.90%,4/31)and the midline group(6.45%,2/31),P>0.05.ConclusionsLaparoscopic D3 radical resection of RCC through caudal combined with midline approach has a better effect,which can shorten the time of postoperative exhaust and defecation,improve the indicators of gastrointestinal hormones,promote the recovery of the body,and reduce the levels of CA125 and CEA,with good safety.

关 键 词：结肠癌 腹腔镜右半结肠癌D3根治术 中线入路 尾侧入路 

分 类 号：R735.35[医药卫生—肿瘤]