摘要
目的探讨腹腔镜下右半结肠癌根治术中间入路术式与侧方入路术式的治疗效果。方法选取2015年1月至2017年12月间上海建工医院收治的94例接受腹腔镜根治术治疗的结肠癌患者,采用随机数字表法分为研究组和对照组,每组47例。研究组患者采用侧方入路,对照组患者采用中间入路,比较两组患者术中和术后相关指标、术中血管损伤率、癌指标活力(Plk2、Livin、TK1、Xiap)及并发症发生率。结果研究组患者手术时间短于对照组,术中出血量少于对照组,两组比较,差异均有统计学意义(均P<0.05)。两组患者淋巴结清扫个数比较,差异无统计学意义(P>0.05)。研究组患者术后排气时间短于对照组,差异有统计学意义(P<0.05)。两组患者术后排便时间、镇痛时间、引流管拔除时间、引流量、进食时间和住院时间比较,差异均无统计学意义(P>0.05)。术后7d,研究组患者Plk1、Livin、TK1和Xiap水平均均低于对照组,差异均有统计学意义(均P<0.05)。研究组患者术中血管损伤率为25.5%(12例),高于对照组的6.4%(3例),差异有统计学意义(P<0.05)。研究组患者并发症总发生率为4.3%,对照组为8.5%,两组比较,差异无统计学意义(P>0.05)。结论侧方入路腹腔镜下右半结肠癌根治术手术时间短,创伤小,病灶切除彻底,癌指标活力明显降低,利于患者预后。
Objective To observe the efficacy of laparoscopy-assisted radical resection in a medial direction versus in a lateral direction for right hemicolectomy.Methods A total of 94 patients with colon cancer who underwent laparoscopy-assisted radical resection for colon cancer at Shanghai Jiangong Hospital from January 2015 to December 2017 were selected and divided into a study group and a control group with47 patients in each group.The study group received surgery in a lateral direction and the control group received surgery in a medial direction.The intraoperative and postoperative related indicators,intraoperative vascular injury rate,activity of cancer indicators（Plk2,Livin,TK1,Xiap） and incidence of complications were compared between two groups.Results The operative time was shorter in the study group than in the control group,and the intraoperative blood loss was less than that of the control group（all P〈0.05）.There was no significant difference in the number of lymph node dissection between the two groups（P〉0.05）.Postoperative exhaust time was shorter in the study group than in the control group（P〈0.05）.There was no significant difference in postoperative defecation time,analgesia time,extubation time,volume of drainage,feeding time and length of hospitalization between the two groups（P〉0.05）.At 7 d after the operation,the levels of Plk1,Livin,TK1 and Xiap in the study group were lower than in the control group（P〈0.05）.The intraoperative vascular injury rate in the study group was 25.5%（12 patients）,which was higher than6.4%（3 patients） in the control group（P〈0.05）.The overall incidence of complications was 4.3% in the study group and 8.5% in the control group（P〉0.05）. Conclusion Laparoscopy-assisted radical resection in a lateral direction for right hemicolectomy has the advantage of short operation time,slight trauma,and complete focal excision,and the activity of cancer indicators decreases significantly.
作者
韩潞
刘兵
谭卫林
HAN Lu;LIU Bing;TAN Wei-lin(Department of General Surgery,Shanghai Jiangong Hospital,Shanghai 200083,China)
出处
《中国肿瘤临床与康复》
2018年第8期919-923,共5页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
右半结肠肿瘤
腹腔镜根治术
中间入路
侧方入路
癌指标活力
血管损伤率
Right colon neoplasms
Laparoscopic radical resection
Medial direction
Lat-eral direction
Activity of cancer indicators
Intraoperative vascular injury rate
