腹腔镜辅助右半结肠癌D3根治术临床安全性及可行性研究

目的探究腹腔镜辅助右半结肠癌D3根治术的临床疗效。 方法回顾性分析2013年1月至2018年10月60例右半结肠癌患者资料，均行右半结肠癌D3根治术。2013年1月至2015年6月30例患者为开腹组；2015年7月至2018年10月30例患者为腹腔镜组。采用统计学软件SPSS 20.0进行数据分析，围术期指标、炎性反应及免疫功能指标采用( ±s)表示，独立t检验；并发症等计数资料采用χ²检验；P<0.05差异有统计学意义。 结果腹腔镜组在手术时间方面长于开腹组，在术中出血量、术后排气排便时间、肠鸣音恢复时间、下床时间及住院时间等方面均优于开腹组(P<0.05)。两组患者术前WBC、CRP及血清胃泌素(GS)水平差异无统计学意义(P>0.05)，术后均明显增加，但腹腔镜组低于开腹组(P<0.05)。两组患者术前CD4、CD8、CD4/CD8比较无统计学意义(P>0.05)；术后均有所改善，但腹腔镜组患者的CD4、CD4/CD8较开腹组明显增高，CD8较开腹组明显降低(P<0.05)。两组患者术后并发症比较无统计学意义(P>0.05)。 结论腹腔镜辅助右半结肠癌D3根治术术中创伤小、出血少，术后恢复快，安全可行。

Clinical safety and feasibility of laparoscopic D3 radical resection for right colon cancer

ObjectiveTo explore the clinical effect of laparoscopic D3 radical resection for right colon cancer. MethodsData of 60 patients with right hemicolon cancer in our hospital from January 2013 to October 2018 were retrospectively analyzed, all of whom underwent right hemicolon cancer D3 radical resection. From January 2013 to June 2015, 30 patients were divided into the open group. 30 patients from July 2015 to October 2018 were divided into the laparoscopic group. Statistical software SPSS 20.0 was used for data analysis. Statistical software SPSS 20.0 was used for data analysis. Measurement data such as perioperative relevant indicators , inflammatory response and immune function indicators were expressed as ( ±s) and were examined by independent t test. The incidence of complications were examined by chi square test. A P value of <0.05 was considered as statistically significant. ResultsCompare with Open group, there was longer operation time, less intraoperative blood loss, quicker postoperative exhaust and defecation time, earlier intestinal rumbling recovery time, shorter time to get out of bed and hospitalization in the Laparoscopic group, with statistically significant differences respectively(P<0.05). There were no significant differences in terms of preoperative WBC, CRP and serum gastrin (GS) levels between two groups (P>0.05). There was no significant difference of preoperative CD4, CD8 and CD4/CD8 between the two groups (P>0.05), but the CD4 and CD4/CD8 in laparoscopic group were significantly higher than those in open group, and CD8 was significantly lower than that in open group (P<0.05). There was no significant difference of postoperative complications between the two groups (P>0.05). ConclusionLaparoscopic D3 radical resection for right colon cancer is safe and feasible with less trauma, less bleeding and rapid recovery.