经脐单孔腹腔镜右半结肠根治手术的临床研究

目的探讨经脐单孔腹腔镜右半结肠根治手术的临床研究。 方法纳入2015年1月至2018年6月于上海交通大学医学院附属瑞金医院北院普外科接受传统5孔腹腔镜右半结肠切除术和纯单孔腹腔镜右半结肠手术的患者共89例，其中单孔腹腔镜手术45例(单孔腹腔镜组)、传统5孔腹腔镜手术44例(传统腹腔镜组)，根据患者的年龄、性别、体质量指数、ASA评分(≤ 2分/>2分)、手术时间、并发症、淋巴结获得数目、病理分期等进行分析。 结果在术中出血量、进食流食时间、术后住院时间方面，单孔腹腔镜组和传统腹腔镜组比较，差异无统计学意义。单孔腹腔镜组的手术时间166 min(42.0 min)比144 min(37.5 min)，P＝0.03]更长。单孔腹腔镜组中出现1例(2.27%)术后吻合口瘘，传统腹腔镜组有1例(2.22%)术后吻合口瘘(P＝0.99)。两组的病理结果相似。单孔腹腔镜组中位随访时间22.5个月、传统腹腔镜组中位随访时间21.9个月。单孔腹腔镜组有3例(6.8%)出现复发、传统腹腔镜组也有3例(6.6%)复发，复发率比较，差异无统计学意义(P＝0.88)。 结论单孔腹腔镜右半结肠癌手术需要在临床和肿瘤学疗效方面与传统五孔腹腔镜手术相当，初步证实是一种安全可开展的手术方式。

A clinical study of transumbilical single-incision laparoscoic surgery for right colon cancer

ObjectiveTo investigate clinical and oncologic outcomes of single-incision laparoscopic surgery (SILS) for right colon cancer. MethodsFrom Jan.2015 to Jun. 2018, 89 patients underwent laparoscopic radical right hemicolectomy through a transumbilical single-incision laparoscopic surgery (n=45) or a conventional 5 ports laparoscopic approach (n=44). The data were prospectively collected and the patients in two groups were compared by index of age, sex, body mass index , comorbidities, ASA score (≤ 2/> 2), operation time, blood loss, harvest of lymph nodes, pathologic stage, etc. ResultsNo significant differences were observed in estimated blood loss, time to diet, postoperative pain score, length of post-operative hospital stay between the SILS and CLS groups. The SILS group showed longer operation time 166 min(42.0 min) vs 144 min (37.5 min), P=0.03]. There were 1(2.27%) postoperative anastomosis leakage in the SILS group and 1 (2.22%) in the CLS group (P=0.99). The pathologic outcomes were similar between two groups. The median follow-up period was 22.5 months in the SILS group and 21.9 months in the CLS group. There were 3 recurrences (6.8%) in the SILS group and 3 (6.6%) in the CLS group(P=0.88). ConclusionsSingle-incision laparoscopic surgery for right colon cancer appears to be a safe and feasible option with comparable clinical and oncologic outcomes to conventional 5 ports laparoscopic surgery.