摘要
目的比较腹腔镜下右半结肠癌根治术与传统开腹中线入路的随机对照观察结果。方法选择2013年6月至2014年4月于我院接受右半结肠癌根治术的患者84例为研究对象。随机分为腹腔镜手术组（腹腔镜组）与传统开腹手术组（开腹组）,每组42例。两组在常规治疗的基础上分别进行腹腔镜根治术与开腹手术,比较两组手术时间、术中出血量、淋巴清扫数目、术后肛门排气时间、恢复进食时间及住院时间,并经随访统计两组术后并发症、肿瘤复发转移、死亡情况。结果两组手术时间、淋巴清扫数目均无显著差异（P〉0.05）,腹腔镜组术出血量为（52.99±16.53）m L,显著低于开腹组（86.57±24.8）m L（P〈0.05）;腹腔镜组肛门排气时间、恢复进食时间及住院时间分别为（2.25±0.84）d、（4.27±1.30）d、（9.33±3.58）d,均明显少于开腹组（P〈0.05）,术后1个月内,腹腔镜组切口感染发生率显著低于对照组（P〈0.05）,两组肠梗阻、尿路感染、吻合口漏发生率无显著差异（P〉0.05）;腹腔镜术后1年生存率为83.33%,开腹组生存率为78.57%,组间相比无明显差异（χ^2=0.309,P〉0.05）。结论以腹腔镜根治术中线入路治疗右半结肠癌,可明显缩短其恢复进程并降低切口感染风险,相对于传统开腹手术微创安全的值得临床推广运用。
Objective To compare the results of randomized controlled observation on laparoscopic radical resection for right-sided colon carcinoma and traditional open midline approach. Methods 84 cases of patients who underwent radical resection for right-sided colon carcinoma in our hospital between June 2013 and April 2014 were selected as the study objects and were randomized into laparoscopic surgery group（laparoscopic group） and traditional open surgery group（open group）, 42 cases in each group. On the basis of routine therapy, the two groups were treated by laparoscopic radical operation and open surgery, respectively. The operation time, intraoperative blood loss, number of lymph node removed, postoperative anal exhaust time, recovery time of taking food and length of hospital stay were compared between the two groups. The conditions of postoperative complications, tumor recurrence and metastasis and mortality in the two groups were statistically analyzed through follow-up. Results There were no significant differences in the operation time and the number of lymph nodes removed between the two groups（P〉0.05）. The bleeding volume of laparoscopic group [（52.99±16.53） m L] was significantly less than that of open group [（86.57±24.8） m L]（P0.05）. The anal exhaust time, recovery time of taking food and length of hospital stay of laparoscopic group [（2.25±0.84） d,（4.27± 1.30） d,（9.33±3.58） d] was significantly shorter than that of open group（P〈0.05）. Within 1 month after the operation, the incidence of incision infection in laparoscopic group was significantly lower than that in control group（P〈0.05）. There were no significant differences in the incidence rates of intestinal obstruction, urinary tract infection and anastomotic leakage between the two groups（P〉0.05）. The survival rate of laparoscopic group in 1 year after surgery was 83.33% while of open group was 78.57%（χ^2=0.309, P〉0.05）. Conclusion The application of laparoscopic radical resection midline approach in the treatment of the right-sided colon carcinoma can significantly shorten the recovery process and reduce the risk of incision infection. Compared with the traditional open surgery, it has advantage of minimal invasion, with safety. It is an operation mode which is worthy of promotion.
出处
《结直肠肛门外科》
2016年第2期188-191,共4页
Journal of Colorectal & Anal Surgery
关键词
腹腔镜
右半结肠癌根治术
开腹
中线入路
Laparoscopic
Radical resection of right-sided colon carcinoma
Open surgery
Midline approach
