尾内侧中间联合入路腹腔镜下根治术治疗右半结肠癌的效果  

Effect of laparoscopic radical rectectomy of right-sided colon cancer via medial caudal combined intermediate approach

作　　者：梁涛 陈学文 张继东[1] LIANG Tao;CHEN Xuewen;ZHANG Jidong(Department of General Surgery Zone 1,People's Hospital of Yingde City Guangdong Province,Guangdong Province,Yingde 513000,China)

机构地区：[1]广东省英德市人民医院普通外科一区,广东英德513000

出　　处：《中国当代医药》2025年第4期71-74,共4页China Modern Medicine

基　　金：广东省清远市科技计划项目(230906208722780)。

摘　　要：目的探讨尾内侧中间联合入路腹腔镜下根治术(LRR)治疗右半结肠癌(RCC)的效果。方法选取2023年1月至2024年9月广东省英德市人民医院收治的60例RCC患者作为研究对象,按照随机数字表法分为中间组(30例)和联合入路组(30例)。两组患者均行LRR治疗,联合入路组采用尾内侧中间联合入路,中间组采用中间入路。比较两组的围手术期指标、肿瘤标志物[癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)]、并发症发生情况。结果联合入路组的住院时间[(7.41±1.34)d]、术后进食时间[(3.15±0.29)d]、手术时间[(151.33±10.48)min]、术后排气时间[(2.86±0.27)d]均短于中间组,术中出血量[(41.87±3.97)ml]少于中间组,差异有统计学意义(P<0.05);两组的中转开腹率、淋巴结清扫数量比较,差异无统计学意义(P>0.05);术后2周,两组患者的CEA、CA125、CA19-9水平均低于本组术前,且联合入路组的CEA、CA125、CA19-9水平均低于中间组,差异有统计学意义(P<0.05);两组患者的并发症总发生率比较,差异无统计学意义(P>0.05)。结论尾内侧中间联合入路LRR治疗RCC可减小手术创伤,缩短患者恢复时间,改善肿瘤标志物水平。Objective To investigate the effect of laparoscopic radical rectectomy(LRR)of right-sided colon cancer(RCC)via medial caudal combined intermediate approach.Methods A total of 60 patients with RCC admitted to People's Hospital of Yingde City Guangdong Province from January 2023 to September 2024 were selected as the research objects.According to the random number table method,they were divided into intermediate group(30 cases)and combined approach group(30 cases).Both groups were treated with LRR.The combined approach group was treated with medial caudal combined intermediate approach,and the intermediate group was treated with intermediate approach.The perioperative indicators,tumor markers(carcinoembryonic antigen[CEA],carbohydrate antigen 125[CA125],carbohydrate antigen 19-9[CA19-9])and complications were compared between the two groups.Results The hospital stay([7.41±1.34]d),postoperative feeding time([3.15±0.29]d),operation time([151.33±10.48]min),postoperative exhaust time([2.86±0.27]d)in the combined approach group were shorter than those in the intermediate group,the intraoperative blood loss([41.87±3.97]ml)was less than that in the intermediate group,and the differences were statistically significant(P<0.05).There were no significant differences in the conversion rate and the number of lymph node dissection between the two groups(P>0.05).Two weeks after operation,the levels of CEA,CA125 and CA19-9 in the two groups were lower than those before operation,and the levels of CEA,CA125 and CA19-9 in the combined approach group were lower than those in the intermediate group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion LRR via medial caudal combined intermediate approach can reduce surgical trauma,shorten the recovery time of patients,and improve the level of tumor markers for RCC.

关 键 词：右半结肠癌 中间入路 腹腔镜下根治术 尾内侧中间联合入路 

分 类 号：R735.35[医药卫生—肿瘤]