腹腔镜辅助与开腹右半结肠癌根治术192例临床分析

目的：对比2006年11”月至2009年7月我院腹腔镜辅助与开腹右半结肠癌根治术的临床资料，探讨腹腔镜辅助右半结肠癌根治术的可行性、安全性及根治性。方法：分析同期57例腹腔镜辅助右半结肠癌根治术（腔镜组）与135例传统开腹右半结肠癌根治术（开腹组）的临床资料，比较两组病例的手术时间、术中出血量、术后肛门排气时间、术后住院时间、术后并发症及淋巴结清扫个数等指标。结果：两组术后并发症（出血、吻合口漏、肠梗阻、肺部感染、泌尿系感染、切口感染）及淋巴结清扫个数差异无统计学意义。腔镜组手术时间较开腹组延长（205．9±63．7）min vs（168．9±57．9）min，（t=3．931，P=0．000）；腔镜组出血量（157．5±143．6）ml明显少于开腹组（239．6±284．3）ml，（t=2．069，P=0．040）；术后排气时间腔镜组（2．98±1．1）d少于开腹组（3．83±1．1）d，（t=-4．861，P=0．000）；术后住院时间腔镜组（10．9±5．2）d少于开腹组（14．2±12．0）d，（t=-2．693，P=0．008）。结论：腹腔镜辅助右半结肠癌根治术是一种安全、可45-的术式．能达到肿瘤根治的要求。

The analysis of laparoscopic-assisted and open abdominal right hemi-colectomy:a report of 192 cases

Objective： To explore the method, the feasibility, safety and curative of radical laparoscopic- assisted right hemi-colectomy for colon cancer by comparing laparoscopic-assisted and open abdominal right hemi- colectomy. Methods： Analyze 57 laparoscopic-assisted right hemi-colectomy （ laparoscopic-assisted group） and 135 traditional abdominal radical hemi-colectomy （open abdominal group） in the corresponding period, compare the operative time, blood loss, postoperative anus exhaust time, postoperative hospital time, postoperative complication and number of dissected lymph nodes in two groups. Results：There were no significant difference between two groups in postoperative complication and number of dissected lymph nodes. The blood loss in laparoscopic-assisted group was less than open abdominal group（ P = 0.040）. The postoperative anus exhaust time and the postoperative hospital time in laparoscopic-assisted group were also less than open abdominal group （ P = 0. 000, 0. 008）, and the operation time in laparoscopic-assisted group was longer than open abdominal group（P = 0. 000）. Conclusions ： The radical laparoscopic-assisted right hemi-colectomy was safe and feasible, and can meet the requirement of radical resection.