单孔加一孔与传统多孔腹腔镜用于右半结肠癌根治术的中远期随访比较

目的分析单孔加一孔与传统多孔腹腔镜用于右半结肠癌根治术的中远期效果。方法回顾性分析2013年1月至2015年5月100例右半结肠癌根治术患者的病例资料,将采用单孔加一孔腹腔镜右半结肠癌根治术治疗的50例患者纳入两孔组,采用传统多孔腹腔镜右半结肠癌根治术治疗的50例患者纳入多孔组。采用SPSS 23.0软件进行数据处理,手术相关指标、生活质量综合评定问卷(GQOLI-74)评分以(x±s)表示,采用独立样本t检验;并发症发生率、肿瘤复发率用百分比表示,用χ²检验;生存率采用Log Rank法检验。P<0.05为差异有统计学意义。结果两孔组手术时间、术中出血量、切口总长度、肠道功能恢复时间、术后48h VAS评分低于多孔组(P<0.05);两组淋巴结清扫数目、并发症发生率、术后3年、5年生存率及肿瘤复发率比较,差异无统计学意义(P>0.05);两孔组患者术后1年GQOLI-74量表中躯体功能、社会功能、心理功能评分高于多孔组(P<0.05)。结论单孔加一孔与传统多孔腹腔镜用于右半结肠癌根治术中淋巴结清扫数目、安全性与中远期预后相似,但前者创伤更小,患者术后疼痛更轻,生活质量更高。

Long-term follow-up of single plus one hole versus conventional porous laparoscopy for radical resection of right colon cancer

Objective To analyze the mid-and long-termeffects of single-hole plus one-hole 1 versus traditional porous laparoscopy for radical resection of right colon cancer.Methods Retrospective analysis of the case data of 100 patients with right colon cancer from January 2013 to May 2015.50 patients with right hemicolectomy by one hole laparoscopy were enrolled into the two hole group,and 50 patients with right hemicolectomy by traditional porous laparoscopy were enrolled into the porous group.SPSS23.0 software was used for processing.Surgical indicators and quality of life questionnaire(GQOLI-74)were expressed by( x±s)and independent t test.The complication rate and recurrence rate were expressed by percentage,and χ²Test;Survival rate is tested by Log Rank method.P<0.05 was considered statistically significant.Results The operation time,intraoperative blood loss,total incision length,intestinal function recovery time and 48 h VAS score in the two-port group were lower than those in the porous group(P<0.05);There was no significant difference in the number of lymph node dissection,incidence of complications,survival rate and tumor recurrence rate between the two groups(P>0.05).The physical function,social function,and psychological function scores in GQOLI-74 scale at 1 year postoperatively were higher than those of the porous group(P<0.05).Conclusion The number,safety and long-term prognosis of lymph node dissection in the radical resection of right colon cancer by single-port plus one-port laparoscopy are similar to those by traditional porous laparoscopy,but the former is less traumatic,less painful,and higher quality of life.