中心性肥胖对右下入路腹腔镜右半结肠根治术患者手术相关指标的影响分析
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摘要
目的探讨中心性肥胖对右下入路腹腔镜根治性右半结肠切除术患者手术相关指标的影响。方法回顾性分析2012年1月至2018年1月于本院接受右下入路腹腔镜根治术的110例右半结肠癌患者临床资料,按是否伴中心性肥胖分为A组(n=66,不伴中心性肥胖)与B组(n=44,伴中心性肥胖)。比较两组手术相关指标差异。结果 A组与B组操作性损伤发生率比较,差异无统计学意义(P> 0.05)。A组术中出血量少于B组,手术时间及术后住院时间短于B组,组间比较差异均有统计学意义(均P <0.05);两组淋巴结清扫数目及术后肛门排气时间比较,差异均无统计学意义(均P> 0.05)。A组与B组并发症总发生率比较,差异无统计学意义(P> 0.05)。结论对接受右下入路腹腔镜根治术的右半结肠癌患者而言,如果伴有中心性肥胖,则可能导致手术时间延长、增加术中出血量。
Objectives To investigate effect of central adiposity on operation-related indices in patients receiving lower-right laparoscopic radical resection of right-sided colon cancer. Methods This was a retrospective analysis of 110 patients who received lower-right laparoscopic radical resection of right-sided colon cancer between January 2012 and January 2018. Patients were divided into normal body weight(group A, n = 66) and central adiposity group(group B, n = 44). Operation-related indices were compared between the two groups. Results There was no significant difference in incidence of operational injury(P >0.05). Blood loss was significantly less, and duration of operation and post-operative hospitalization significantly shorter in group A than group B(P < 0.05). Number of dissected lymph nodes, time to postoperative anal exhaust, and incidence of complications were comparable between the two group(P > 0.05). Conclusion Central adiposity could increase duration of operation and intraoperative blood loss in patients who receive lower-right laparoscopic radical resection of right-sided colon cancer.
Objectives To investigate effect of central adiposity on operation-related indices in patients receiving lower-right laparoscopic radical resection of right-sided colon cancer. Methods This was a retrospective analysis of 110 patients who received lower-right laparoscopic radical resection of right-sided colon cancer between January 2012 and January 2018. Patients were divided into normal body weight(group A, n = 66) and central adiposity group(group B, n = 44). Operation-related indices were compared between the two groups. Results There was no significant difference in incidence of operational injury(P >0.05). Blood loss was significantly less, and duration of operation and post-operative hospitalization significantly shorter in group A than group B(P < 0.05). Number of dissected lymph nodes, time to postoperative anal exhaust, and incidence of complications were comparable between the two group(P > 0.05). Conclusion Central adiposity could increase duration of operation and intraoperative blood loss in patients who receive lower-right laparoscopic radical resection of right-sided colon cancer.
引文
[1]杨先铭.腹腔镜在全结肠系膜切除术治疗右半结肠癌中的应用体会[J].结直肠肛门外科, 2017, 22(1):16-19.
[2]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.
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[6]朱达坚,陈小伍,剧永乐,等.以回结肠血管为标记右下入路在腹腔镜根治性右半结肠切除术中的临床应用[J].实用医学杂志,2012, 28(12):2039-2041.
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[9] EDGE S B, COMPTON C C. The American Joint Committee on Cancer:the 7thedition of the AJCC cancer staging manual and the future of TNM[J]. Ann Surg Oncol, 2010, 17(6):1471-1474.
[10]韩雪,黄辰曦,赵佳,等.上海市杨浦区2002-2012年户籍人口结直肠癌发病和生存分析[J].中华流行病学杂志, 2014, 35(3):289-294.
[11]巫娜,廖娟.腹腔镜右半结肠癌完整结肠系膜切除术的效果及对血浆miR-21表达水平的影响[J].结直肠肛门外科, 2018, 24(3):264-267.
[12]刘宏斌,李洪涛,于建平,等.腹腔镜中间入路右半结肠癌根治术[J].中华消化外科杂志, 2015, 14(6):503-506.
[13]沈荐,李敏哲,杜燕夫,等.肥胖对腹腔镜右半结肠癌完整结肠系膜切除疗效的影响[J].中国微创外科杂志, 2018, 18(2):110-113.
[14]喻鑫,张佳佳,曹先东.腹腔镜下不同手术入路右半结肠癌根治术对比研究[J].贵州医药, 2017, 41(12):1317-1318.
[15]马冰,杜晓辉,夏绍友,等.回结肠血管为入路标志的腹腔镜辅助下右半结肠根治术24例报告[J].中国微创外科杂志, 2013, 13(6):481-484.
[2]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.
[3]郝云鹤,王连臣,候本新,等.腹腔镜下不同入路行右半结肠癌根治术临床疗效观察[J].海南医学,2015, 26(17):2598-2600.
[4]赵根隆,陈裕.中间入路腹腔镜全系膜切除术治疗右半结肠癌的临床疗效[J].中华消化外科杂志, 2014, 13(8):645-647.
[5]邱东达.比较腹腔镜手术与常规开腹手术对右半结肠癌切除术后创伤应激的影响[J].结直肠肛门外科, 2018, 24(1):31-34.
[6]朱达坚,陈小伍,剧永乐,等.以回结肠血管为标记右下入路在腹腔镜根治性右半结肠切除术中的临床应用[J].实用医学杂志,2012, 28(12):2039-2041.
[7] KANEKO R, NAKAZAKI N, TAGAWA T, et al. A new index of abdominal obesity which effectively predicts risk of colon tumor development in female Japanese[J]. Asian Pac J Cancer Prev, 2014, 15(2):1005-1010.
[8]中国肥胖问题工作组.中国成人超重和肥胖症预防与控制指南(节录)[J].营养学报, 2004, 26(1):1-4.
[9] EDGE S B, COMPTON C C. The American Joint Committee on Cancer:the 7thedition of the AJCC cancer staging manual and the future of TNM[J]. Ann Surg Oncol, 2010, 17(6):1471-1474.
[10]韩雪,黄辰曦,赵佳,等.上海市杨浦区2002-2012年户籍人口结直肠癌发病和生存分析[J].中华流行病学杂志, 2014, 35(3):289-294.
[11]巫娜,廖娟.腹腔镜右半结肠癌完整结肠系膜切除术的效果及对血浆miR-21表达水平的影响[J].结直肠肛门外科, 2018, 24(3):264-267.
[12]刘宏斌,李洪涛,于建平,等.腹腔镜中间入路右半结肠癌根治术[J].中华消化外科杂志, 2015, 14(6):503-506.
[13]沈荐,李敏哲,杜燕夫,等.肥胖对腹腔镜右半结肠癌完整结肠系膜切除疗效的影响[J].中国微创外科杂志, 2018, 18(2):110-113.
[14]喻鑫,张佳佳,曹先东.腹腔镜下不同手术入路右半结肠癌根治术对比研究[J].贵州医药, 2017, 41(12):1317-1318.
[15]马冰,杜晓辉,夏绍友,等.回结肠血管为入路标志的腹腔镜辅助下右半结肠根治术24例报告[J].中国微创外科杂志, 2013, 13(6):481-484.