腹腔镜尾侧联合中央入路右半结肠癌根治术的临床分析

目的比较腹腔镜尾侧联合中央入路右半结肠癌根治术和腹腔镜中央入路右半结肠癌根治术的临床效果,探讨腹腔镜尾侧联合中央入路右半结肠癌根治术的临床意义。方法回顾性分析2017年1月至2019年12月在本院外科行腹腔镜下右半结肠癌根治术的48例患者的临床资料,按手术入路分为观察组和对照组,每组24例。观察组行尾侧联合中央入路手术,对照组行中央入路手术。比较两组临床资料、手术平均时间、术中出血量、清扫淋巴结数量、首次排气时间、恢复流质饮食时间、术后并发症发生率、癌症病理类型和病理分期。结果观察组手术时间短于对照组,出血量少于对照组,差异有统计学意义(P<0.05);两组清扫淋巴数量比较差异无统计学意义。两组患者肿瘤病理类型和病理分期比较差异无统计学意义;两组患者术后恢复排气、拔除引流管、恢复流质饮食时间比较差异无统计学意义;两组患者术后并发症发生率比较差异无统计学意义。结论腹腔镜尾侧联合中央入路右半结肠癌根治术可缩短手术时间、减少出血量,且不增加并发症发生率,安全性较高。

Clinical analysis of caudal-to-crainaland medial-to-lateral approach for laparoscopic right-hemicolectom-surgery

Objective To compare the clinical effects of laparoscopic caudal combined with central approach for right colon cancer and laparoscopic central approach for right colon cancer,and to explore the clinical significance of laparoscopic caudal combined with central approach for right colon cancer.Methods The clinical data of 48 patients who underwent laparoscopic radical resection of right colon cancer in our hospital from January 2017 to December 2019 were collected,and they were divided into observation group and control group,with 24 cases in each group according to surgical approach.The general data,average operation time,intraoperative blood loss,number of lymph nodes dissected,first exhaust time,recovery time of fluid diet,postoperative complications,pathological types and pathological stages of cancer were compared between the two group.Results The operation time of the observation group was shorter than that of the control group,and the amount of bleeding was less than that of the control group,the difference was statistically significant(P<0.05);there was no statistically significant difference in the number of lymph dissection between the two groups.There was no statistically significant difference in tumor pathological type and pathological stage between the two groups of patients;there was no statistically significant difference in the time of postoperative recovery of exhaust gas,drainage tube removal and liquid diet between the two groups;there was no significant difference in the incidence of postoperative complications between the two groups.Conclusion Laparoscopic caudal combined with central approach for radical resection of right colon cancer is safe and feasible,intraoperative plane anatomy and vascular anatomy are safe,which is beneficial to beginners and basic hospitals.