腹腔镜右半结肠切除术改良路径的应用

目的 探讨改良手术路径在腹腔镜右半结肠切除术中的应用.方法 采用回顾性研究的方法,选取右半结肠癌患者97例.根据不同的手术路径分为观察组(改良腔镜手术组,n =48)和对照组(传统腔镜手术组,n=49).主要观察比较两种手术路径的手术质量相关指标(手术时间、术中出血量和中转手术例数),其次观察比较术后恢复情况[排气时间、淋巴结清扫个数、并发症(肺部感染、切口感染、吻合口漏)].结果 改良腔镜手术组的手术时间短于传统腔镜手术组[(124.0±27.8) nin vs(156.0±43.6) min,t=4.303,P＜0.05],在术中出血量、中转手术例数、术后排气时间、术后并发症(肺部感染、切口感染、吻合口漏)等方面两组差异无统计学意义(P＞0.05).结论 腹腔镜右半结肠切除改良路径使手术时间缩短,是一种更容易操作、稳定、规律的手术路径,值得临床推广.

Application of improved surgical approach in laparoscopic right hemicolectomy

Objective To explore application of improved surgical approach in laparoscopic right hemicolectomy.Methods Ninty-seven patients with right hemicolonic cancer were divided into the observational group(improved laparoscopic surgery group,n =48) and the control group(traditional laparoscopic surgery group,n =49).The surgery quality-related indicators (the operation time,intraoperative blood,the incidence of convertion to laparotomy and the number of dissected lymph node) were the main observation target,and postoperative recovery (exhaust time and the incidence of postoperative complications,including the lung infection,incision infection and anastomotic fistula) were the secondary observation target.Results The average operation time in improved laparoscopic surgery group was shorter than that in traditional laparoscopic surgery group [(124.0 ±27.8) min vs (156.0 ±43.6) min,t =4.303,P＜0.05].No significant differences were found in intraoperative blood,the number of dissected lymph node,exhaust time,the incidence of convertion to laparotomy and postoperative complications including the lung infection,incision infection and anastomotic fistula (P ＞ 0.05).Conclusions Application of improved surgical approach in laparoscopic right hemicolectomy could shorten operation time and it,with better control,stability and regularity,is worth to be spread in clinical practice.