进气Trocar布局对腹腔镜直肠癌根治联合盆腔淋巴结清扫术除烟雾效果的影响  

Effect of Insufflation Trocar Configuration on Surgical Smoke Evacuation in Laparoscopic Radical Resection of Rectal Cancer Combined with Pelvic Lymph Node Dissection

作　　者：卢英波 LU Ying-bo(Tianjin People's Hospital,Tianjin 300121)

机构地区：[1]天津市人民医院,天津300121

出　　处：《中国肛肠病杂志》2025年第3期15-17,共3页Chinese Journal of Coloproctology

摘　　要：目的:探讨不同进气Trocar布局对腹腔镜直肠癌根治联合盆腔淋巴结清扫术除烟雾效果的影响。方法:选取2017年6月至2022年12月,天津市人民医院收治的135例腹腔镜直肠癌根治联合盆腔淋巴结清扫术患者,随机分为观察组68例和对照组67例。观察组将进气孔连于超声刀Trocar,吸引器连于左下腹Trocar进行手术。对照组将进气孔连于镜头Trocar,吸引器连于左下腹Trocar进行手术。比较2组手术时间,CO_(2)消耗量和擦镜次数等指标。结果:观察组手术时间明显短于对照组[(390.0±85.7)min vs(422.5±101.2)min],术中出血量少于对照组[(142.1±115.6)mL vs(245.4±189.6)mL],平均每小时擦镜次数少于对照组[(4.5±1.4)次vs(8.5±2.0)次],每小时CO_(2)消耗量低于对照组[(301.8±30.1)L vs(312.4±27.2)L],术中意外出血次数少于对照组[(5.1±2.9)次vs(7.9±3.7)次],术后住院时间短于对照组[(17.7±12.6)d vs(19.1±9.0)d]。结论:腹腔镜直肠癌根治术联合盆腔淋巴结清扫术中,经右下腹Trocar进气,左下腹Trocar排气相较于传统经中央镜头Trocar进气左下腹Trocar排气效果更好,能明显改善腹腔镜视野清晰度,减少擦镜次数,减少手术时间和术中出血量,临床效果显著。Objective To investigate the effect of different insufflation Trocar configurations on surgical smoke evacuation during laparoscopic radical resection of rectal cancer combined with pelvic lymph node dissection.Methods A total of 135 patients undergoing the procedure at Tianjin People's Hospital from June 2017 to December 2022 were enrolled and randomly divided into the observation group(68 cases)and the control group(67 cases).In the observation group,the insufflation port was connected to the ultrasonic scalpel Trocar,and the suction device was connected to the left lower abdominal Trocar.In the control group,the insufflation port was connected to the laparoscope Trocar,with the suction device similarly placed in the left lower abdomen Trocar.Comparative metrics included operative time,CO_(2) consumption,lens cleaning frequency,etc.in the two groups.Results The observation group demonstrated significantly shorter operative time[(390.0±85.7)min vs.(422.5±101.2)min],reduced intraoperative blood loss[(142.1±115.6)mL vs.(245.4±189.6)mL],fewer lens cleanings per hour[(4.5±1.4)vs.(8.5±2.0)],lower CO_(2) consumption per hour[(301.8±30.1)L vs.(312.4±27.2)L],fewer intraoperative bleeding incidents[(5.1±2.9)vs.(7.9±3.7)],and shorter postoperative hospitalization[(17.7±12.6)d vs.(19.1±9.0)d]compared to the control group.Conclusion In laparoscopic radical resection of rectal cancer with pelvic lymph node dissection,utilizing the right lower abdominal Trocar for insufflation and the left lower abdominal Trocar for surgical smoke evacuation is superior to the traditional central laparoscope Trocar insufflation method.This configuration significantly improves visual clarity,reduces lens cleaning frequency,shortens operative time,and decreases intraoperative bleeding,demonstrating notable clinical efficacy.

关 键 词：直肠癌 腹腔镜根治术 盆腔淋巴结清扫 手术烟雾 效果 

分 类 号：R735.3[医药卫生—肿瘤]