开腹右半结肠癌根治术与腹腔镜辅助右半结肠癌根治术的效果比较分析
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摘要
目的比较开腹右半结肠癌根治术和腹腔镜辅助右半结肠癌根治术的手术安全性及临床疗效。方法选取2013年5月～2015年5月我院收治的83例右半结肠癌患者,按随机数字表法分为两组,腹腔镜组40例采用腹腔镜辅助右半结肠癌根治术,传统组43例行开腹右半结肠癌根治术。比较两组的手术情况、术后恢复程度、手术安全性、住院费用及随访情况。结果腹腔镜组术后排气时间、手术中出血量、切口直径、住院时间、首次下床时间及切口感染明显低于传统组(P<0.05);腹腔镜组与传统组的手术时间、切除淋巴结数量、肠梗阻、吻合口瘘、吻合口狭窄、住院费用、转移率及存活率比较,差异无统计学意义(P>0.05)。结论与开腹右半结肠癌根治术比较,腹腔镜辅助右半结肠癌根治术术后并发症少,预后效果良好,是一种安全有效并能达到肿瘤根治效果的手术方式。
Objective To compare the safety and clinical efficacy of open right colon cancer radical resection and laparoscopic right colon cancer radical resection. Methods A total of 83 patients with right colon cancer admitted from May2013 to May 2015 in our hospital were selected and divided into two groups according to the random number table method. 40 patients in the laparoscopic group were treated with laparoscopic assisted right colon cancer radical surgery.43 patients in the traditional group were given open right colon cancer radical resection. The operation situation, postoperative recovery degree, surgical safety, hospitalization costs and follow-up were compared between the two groups.Results Postoperative drainage time, intra operative blood loss, incision diameter, length of hospital stay, the first time to get out of bed and incision infection was significantly lower in the laparoscopic group than those in the traditional group(P<0.05). There was no significant difference in the operative time, the number of lymph nodes removed, intestinal obstruction, anastomotic leakage, anastomotic stenosis, hospitalization costs, metastasis rate, and survival rate laparoscopic group and conventional group(P>0.05). Conclusion Compared with open right colon cancer radical surgery, laparoscopic assisted radical right colon cancer surgery has fewer postoperative complications and better prognosis. It is a safe and effective surgical method that can achieve the effect of tumor radical resection.
Objective To compare the safety and clinical efficacy of open right colon cancer radical resection and laparoscopic right colon cancer radical resection. Methods A total of 83 patients with right colon cancer admitted from May2013 to May 2015 in our hospital were selected and divided into two groups according to the random number table method. 40 patients in the laparoscopic group were treated with laparoscopic assisted right colon cancer radical surgery.43 patients in the traditional group were given open right colon cancer radical resection. The operation situation, postoperative recovery degree, surgical safety, hospitalization costs and follow-up were compared between the two groups.Results Postoperative drainage time, intra operative blood loss, incision diameter, length of hospital stay, the first time to get out of bed and incision infection was significantly lower in the laparoscopic group than those in the traditional group(P<0.05). There was no significant difference in the operative time, the number of lymph nodes removed, intestinal obstruction, anastomotic leakage, anastomotic stenosis, hospitalization costs, metastasis rate, and survival rate laparoscopic group and conventional group(P>0.05). Conclusion Compared with open right colon cancer radical surgery, laparoscopic assisted radical right colon cancer surgery has fewer postoperative complications and better prognosis. It is a safe and effective surgical method that can achieve the effect of tumor radical resection.
引文
[1]夷青,申俊龙,吕顺军.背侧入路腹腔镜辅助右半结肠切除术的临床探讨[J].中国医师杂志,2016,18(10):1552-1554.
[2]杨世斌,韩方海,肖隆斌,等.腹腔镜辅助右半结肠癌根治术与开放手术的临床应用比较[J].实用医学杂志,2016,32(11):1819-1822.
[3]张帅,徐靖,赵永捷.全结肠系膜切除在腹腔镜右半结肠手术中的应用[J].中国中西医结合外科杂志,2016,22(3):265-267.
[4]牟东成,杨国山,朱建平,等.腹腔镜扩大右半结肠癌根治术手术体会[J].中国临床医生杂志,2018,46(1):57-59.
[5]陈峻青,夏志平.胃肠癌手术学[M].第2版.北京:人民卫生出版社,2008:284-290.
[6]史建中,钱山青,孙卫东,等.中间入路法腹腔镜右半结肠癌根治术55例临床体会[J].腹腔镜外科杂志,2016,21(10):742-745.
[7]张恒春,于伟光,董理,等.腹腔镜下右半结肠癌完整结肠系膜切除术43例临床分析[J].中华实用诊断与治疗杂志,2016,30(8):775-776.
[8]金留根,谢立飞,费伯健,等.腹腔镜完整结肠系膜切除在右半结肠癌根治术的应用[J].江苏医药,2016,42(3):351-352.
[9]蔡永华,张兴伟,侯煜杰,等.尾内侧入路单向环路式腹腔镜辅助右半结肠癌根治术的临床疗效[J].中华消化外科杂志,2016,15(9):928-932.
[10]徐东楚,郭云虎,包磊,等.腹腔镜下右半结肠癌根治术不同手术入路的疗效比较[J].中国现代普通外科进展,2016,19(3):226-228.
[11]张艳辉,李红伟.腹腔镜右半结肠癌根治术与开腹手术的疗效对比[J].中国现代普通外科进展,2016,19(6):496-499.
[12]黄晓天,马冰,杜晓辉,等.小肠系膜根部入路腹腔镜辅助下右半结肠癌根治术20例[J].解放军医学院学报,2017,38(8):735-737,773.
[13]尹林,黄客增,蔡尚坤.腹腔镜与传统开腹根治术治疗右半结肠癌临床疗效的对比分析[J].实用癌症杂志,2016,31(10):1669-1671.
[14]吴浩旋,张弢,季晓频,等.三孔法腹腔镜右半结肠癌根治术的初步探索[J].中华胃肠外科杂志,2016,19(3):278-283.
[15]刁德昌,卢新泉,何耀彬,等.动脉优先入路法腹腔镜右半结肠癌根治术的可行性及应用价值[J].中华胃肠外科杂志,2017,20(1):90-93.
[16]程涛,樊理华,朱锡元,等.中间入路腹腔镜辅助右半结肠癌根治术的临床研究[J].中国现代医生,2017,55(6):19-21.
[17]郭培东,张鲁洲.腹腔镜辅助右半结肠癌根治术与开腹手术的临床应用比较[J].中国现代医生,2018,56(11):13-45.
[18]张锐明,江腾.腹腔镜两种中间入路在右半结肠癌根治术中的疗效比较[J].中国医药科学,2017,7(4):157-159.
[2]杨世斌,韩方海,肖隆斌,等.腹腔镜辅助右半结肠癌根治术与开放手术的临床应用比较[J].实用医学杂志,2016,32(11):1819-1822.
[3]张帅,徐靖,赵永捷.全结肠系膜切除在腹腔镜右半结肠手术中的应用[J].中国中西医结合外科杂志,2016,22(3):265-267.
[4]牟东成,杨国山,朱建平,等.腹腔镜扩大右半结肠癌根治术手术体会[J].中国临床医生杂志,2018,46(1):57-59.
[5]陈峻青,夏志平.胃肠癌手术学[M].第2版.北京:人民卫生出版社,2008:284-290.
[6]史建中,钱山青,孙卫东,等.中间入路法腹腔镜右半结肠癌根治术55例临床体会[J].腹腔镜外科杂志,2016,21(10):742-745.
[7]张恒春,于伟光,董理,等.腹腔镜下右半结肠癌完整结肠系膜切除术43例临床分析[J].中华实用诊断与治疗杂志,2016,30(8):775-776.
[8]金留根,谢立飞,费伯健,等.腹腔镜完整结肠系膜切除在右半结肠癌根治术的应用[J].江苏医药,2016,42(3):351-352.
[9]蔡永华,张兴伟,侯煜杰,等.尾内侧入路单向环路式腹腔镜辅助右半结肠癌根治术的临床疗效[J].中华消化外科杂志,2016,15(9):928-932.
[10]徐东楚,郭云虎,包磊,等.腹腔镜下右半结肠癌根治术不同手术入路的疗效比较[J].中国现代普通外科进展,2016,19(3):226-228.
[11]张艳辉,李红伟.腹腔镜右半结肠癌根治术与开腹手术的疗效对比[J].中国现代普通外科进展,2016,19(6):496-499.
[12]黄晓天,马冰,杜晓辉,等.小肠系膜根部入路腹腔镜辅助下右半结肠癌根治术20例[J].解放军医学院学报,2017,38(8):735-737,773.
[13]尹林,黄客增,蔡尚坤.腹腔镜与传统开腹根治术治疗右半结肠癌临床疗效的对比分析[J].实用癌症杂志,2016,31(10):1669-1671.
[14]吴浩旋,张弢,季晓频,等.三孔法腹腔镜右半结肠癌根治术的初步探索[J].中华胃肠外科杂志,2016,19(3):278-283.
[15]刁德昌,卢新泉,何耀彬,等.动脉优先入路法腹腔镜右半结肠癌根治术的可行性及应用价值[J].中华胃肠外科杂志,2017,20(1):90-93.
[16]程涛,樊理华,朱锡元,等.中间入路腹腔镜辅助右半结肠癌根治术的临床研究[J].中国现代医生,2017,55(6):19-21.
[17]郭培东,张鲁洲.腹腔镜辅助右半结肠癌根治术与开腹手术的临床应用比较[J].中国现代医生,2018,56(11):13-45.
[18]张锐明,江腾.腹腔镜两种中间入路在右半结肠癌根治术中的疗效比较[J].中国医药科学,2017,7(4):157-159.