腹腔镜下不同手术入路根治术治疗右半结肠癌疗效研究

目的探讨腹腔镜下不同手术入路根治术治疗右半结肠癌的疗效。方法选取2012年1月—2015年12月于我院接受腹腔镜手术治疗的右半结肠癌患者90例,统计患者的一般资料并按照中间入路和尾侧中间联合入路方式分为Ⅰ、Ⅱ两组,记录并分析两组手术时间、术中出血量、清扫淋巴结数量等术中情况以及恢复排气排便时间、引流时间、住院时间等术后情况;用Sysmex全血细胞分析仪分别对两组患者手术前后白细胞进行计数。结果两组患者的一般资料均无显著性差异(P>0.05);相比Ⅰ组(中间入路),Ⅱ组(尾侧中间联合入路)所需手术时间显著减少,清扫淋巴结总数以及阳性淋巴结个数显著增多(P<0.05);Ⅱ组引流时间长,引流量大,患者中位生存期长,术后3年存活率高,与Ⅰ组相比差异具有统计学意义(P<0.05);同组内比较,手术后患者血清中白细胞数水平显著升高(P<0.05)。两组间比较,手术前两组血清中白细胞数差异不显著(P>0.05);手术后两组白细胞数亦无显著性差异(P>0.05)。结论腹腔镜手术中采用尾侧中间联合入路方式治疗右半结肠癌,具有较好的远期疗效。

Effects of Laparoscopic Radical Resection With Different Surgical Approaches on the Treatment of Right Hemicolon Carcinoma

Objective To investigate the curative effect of laparoscopic radical resection with different surgical approaches in the treatment of right hemicolon carcinoma.Methods 90 cases of right hemi colon cancer patients who received laparoscopic surgery in our hospital from January 2012 to December 2015 were selected.Statistics of the patient's general information and according to the middle approach and caudal intermediate combined approach divided intoⅠ,Ⅱtwo groups.The operative time,intraoperative blood loss,number of lymph nodes dissected and other intraoperative conditions of the two groups were recorded and analyzed,as well as postoperative conditions such as recovery time of exhaust and defecation,drainage time and hospitalization time.The white blood cells were counted by Sysmex hematology analyzer before and after operation.Results There was no significant difference in general data between the two groups(P>0.05).Compared with groupⅠ(middle approach),the operative time of groupⅡ(caudal intermediate combined approach)was significantly reduced,total number of dissected lymph nodes and the number of positive lymph nodes increased significantly in groupⅡ(P<0.05).The drainage time was long,the drainage flow was large,the median survival time was longer and the 3-year survival rate was higher in groupⅡthan that in groupⅠ,the difference is statistically significant(P<0.05).Comparison within the same group,the number of white blood cells were significantly increased(P<0.05).There was no significant difference in white blood cell count between the two groups after operation(P>0.05).Conclusion In laparoscopic surgery,the right semicolon cancer is treated by the method of caudal middle combined approach,have a good long-term efficacy.