手助腹腔镜下右半结肠癌根治术不同手术入路的临床疗效对比

目的:对比分析不同手助腹腔镜下右半结肠癌根治术中采用不同手术入路的临床疗效。方法 :选取2008年1月—2013年3月收治的80例右半结肠癌患者,将所有患者按随机数法分为实验组与对照组,2组均为40例。实验组接受外侧入路,对照组接受中间入路,比较2组患者术中的一般情况及短期疗效。结果:实验组手术时间(131.3±17.5)min,术中出血(57.9±16.5)m L,对照组分别为(187.3±16.2)min和(104.5±19.8)m L,实验组少于对照组(t=14.852、11.435,P均0.05),2组术中标本切除长度、淋巴结清除个数、术后体温恢复正常时间、排气时间与住院时间的差异无统计学意义(P0.05);2组并发症发生率的差异无统计学意义(10.0%vs 17.5%,χ2=0.949,P=0.330)。结论:在手辅助腔镜下右半结肠癌根治术中,外侧入路出血少,手术时间短,但中间入路更有利于解剖结构的暴露及肿瘤的根治。

Comparison of clinical effect of different surgical approach in hand-assisted laparoscopic hemicolectomy for right colon carcinoma

Objective：To compare the clinical effect of different surgical approach in hand-assisted laparoscopic hemicolectomy for right colon carcinoma.Methods：80 patients with right colon carcinoma who came to our hospital from January,2008 March,2013 were randomly divided into the experimental group and the control group.There were 40 cases in each group.The experimental accepted lateral approach while the control group accepted intermediate approach.The general situation and short-term effect of the two groups was compared.Results：Operative time （131.3 ± 17.5）min and blood loss（57.9 ± 16.5）mL of the experimental group was significantly less than that of the control group （187.3 ± 16.2）min and （104.5 ± 19.8）mL,t=14.852 and 11.435,P=0.000 and 0.000].Difference of specimens resected length,number of lymph node dissection,postoperative body temperature returned to normal time,exhaust time and hospital stay between the two groups was not statistically significant differences （t=1.620 and 0.121,P=0.109 and 0.728）.The difference of complication rate between the two groups was not statistically significant different （10.0％ vs 17.5％,x 2=0.949,P=0.330）.Conclusion：In hand-assisted laparoscopic hemicolectomy for right colon carcinoma,lateral approach has less bleeding and shorter operative time,but Intermediate approach is more conducive to the anatomical structure of the radical exposure and tumor.