尾侧入路与中间入路行腹腔镜下右半结肠癌根治术临床对比

目的 比较尾侧入路法腹腔镜下右半结肠癌根治术与中间入路法腹腔镜下右半结肠癌根治术的近期临床疗效.方法 回顾性分析2014年6月至2017年6月昆明医科大学第一附属医院胃肠外科行腹腔镜下右半结肠癌根治术的124例患者的临床资料, 其中, 尾侧入路组48例, 中间入路组76例, 比较2组患者的基本资料、手术时间、术中出血量、淋巴结清扫数目、中转开腹率、术后恢复流质饮食时间、术后排气时间、术后住院时间、并发症等, 比较2种入路方法的近期临床效果.结果 2组患者的性别、年龄、BMI等基本资料比较, 差异无统计学意义 (P>0.05) ;尾侧入路组与中间入路组手术时间 (123.29 14.19) min vs (140.57 25.40) min]、术中出血量 (60.63 24.00) m L vs (77.24 36.90) m L]比较, 差异有统计学意义 (P<0.05) ;2组患者淋巴结清扫数目、中转开腹率、术后恢复流质饮食时间、术后排气时间、术后住院时间及并发症发生情况比较, 差异无统计学意义 (P>0.05) .结论 尾侧入路法腹腔镜下右半结肠癌根治术具有简单易行、失血量少、安全有效的优点, 值得临床推广应用.

Clinical Contrastive Study between Caudal-to-crainal and Medial-to-lateral Approaches for Laparoscopic Right Hemicolectomy

Objective To compare the short-term therapeutic effects of the caudal-to-crainal and medial-to-lateral approaches for laparoscopic right hemicolectomy. Me thod The clinical data of 124 patients underwent laparoscopic right hemicolectomy in the department of gastrointestinal surgery, the First Affiliated Hospital of Kunming Medical Universitiy from, June 2014 to June 2016, were analyzed retrospectively. According the surgical operation, the patients were divided into two groups, caudal-to-crainal group with 48 patients, and medial-to-lateral group with 76 patients. The characteristics, opertation time, volum of blood loss during operation, the number of lymph node dissection, the rate of conversion to laparotomy, postoperative eating time, postoperative ventilation time, postoperative hospital stay time, postoperative complications of the two groups were analyzed to compare the short-term therapeutic effects. Re s ult No significant differences were found in the sexual distinction, age, BMI, the volume blood loss during the operation, the number of lymph node dissection, the rate of conversion to laparotomy, postoperative eating time, postoperative ventilation time, postoperative hospital stay time, postoperative complications between the two groups (P>0.05) .Significant differences were found in the operation time caudal-to-crainal group vs medial-to-lateral group (123.49 ±14.19 min VS 140.57 ±25.40 min) ]and the blood loss of the operationcaudal-to-crainal group vs medial-to-lateral group (60.63±24.00 ml vs77.24±36.90 ml) ].Conclus ionThe caudal-to-crainal approach for laparoscopic right hemicolectomy is more simple, practicable, with less blood loss during the operation and safer, which worth being recommended in right-hemicolectom-surgery.