急诊直乙状结肠癌梗阻行腹腔镜Hartmann术16例的可行性报告

目的探讨急诊直乙状结肠癌梗阻患者行腹腔镜Hartmann术(LH)的安全性及可行性。方法回顾性分析我院收治的422例直乙状结肠癌患者的临床病例资料,其中45例急诊行Hartmann术。根据手术方法不同对其进行分组,27例行开腹Hartmann术(OH)纳入OH组,16例行LH纳入LH组。比较两组的术中情况、病理分期及术后情况。结果LH组的手术时间长于OH组,术中出血量少于OH组,肿瘤最大径小于OH组(P<0.05)。OH组的外科相关并发症总发生率高于LH组(P<0.05)。LH组的住院时间短于OH组(P<0.05)。LH组术后4、24 h VAS评分低于OH组(P<0.05)。两组均无手术死亡事件发生。结论相比于开放手术,直乙状结肠癌梗阻患者行腹腔镜急诊Hartmann手术是安全可行的。

Feasibility report of laparoscopic Hartmann operation in 16 cases of obstruction of straight sigmoid colon cancer in emergency department

Objective To explore the safety and feasibility of laparoscopic Hartmann operation(LH)in patients with obstruction of straight sigmoid colon cancer in emergency department.Methods The clinical case data of 422 patients with straight sigmoid colon cancer admitted in our hospital were analyzed retrospectively,45 cases of the patients underwent Hartmann operation in emergency.The patients were grouped according to the different surgical methods,27 patients underwent open Hartmann operation(OH)were included in OH group,and 16 patients underwent LH were included in LH group.The intraoperative conditions,pathological stages and postoperative conditions of patients in the two groups were compared.Results The operation time of the LH group was longer than that of the OH group,the intraoperative blood loss volume was less than that of the OH group,and the largest tumor diameter was smaller than that of the OH group(P<0.05).The total incidence of surgery-related complications in the OH group was higher than that in the LH group(P<0.05).The hospital stay in the LH group was shorter than that in the OH group(P<0.05).The VAS scores at 4 and 24 hours after operation of the LH group were lower than those of the OH group(P<0.05).There were no surgical deaths in the two group.Conclusion Compared with open surgery,laparoscopic Hartmann surgery in emergency department is safe and feasible for patients with straight sigmoid colon cancer.