尾中联合入路与头中入路在腹腔镜右半结肠癌不完全肠梗阻全肠系膜切除术中的疗效比较

中国综合临床 Pub Date : 2020-03-01 DOI:10.3760/CMA.J.ISSN.1008-6315.2020.02.006

Hongsheng Zhao, Jiyong Pan, Ruifeng Yan, Zijun Guo, Long Yan

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引用次数: 0

摘要

目的比较腹腔镜下完全性中结肠切除术（CME）中尾联合入路与头中入路治疗右半结肠癌合并不完全性肠梗阻的疗效。方法回顾性分析2014年1月至2019年1月大连市第三人民医院收治的90例右半结肠癌合并不完全性肠梗阻患者的临床资料。所有患者均行腹腔镜右半结肠切除术、CME加D3淋巴结清扫术。根据不同手术入路的选择，44例患者采用中-尾联合入路（观察组），46例患者采用头-中入路（对照组）。对两组患者术中、术后及并发症进行统计学比较。结果与对照组相比，观察组出血量明显减少（（105.3±22.6）ml vs.（309.6±28.0）ml，t=13.698），手术时间明显缩短（（165.2±17.9）min vs.（219.5±21.5）min，t=8.327），结论应用中尾入路腹腔镜右结肠癌合并不完全性肠梗阻行CME是安全可行的。与头正中入路相比，可减少出血量，缩短手术时间。关键词：右结肠癌癌症；不完全性肠梗阻；完全性结肠系膜切除术；中尾联合入路

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Comparison of the efficacy of midcaudal combined approach and cephalic middle approach in laparoscopic complete mesocolic excision for right hemicolon cancer with incomplete ileus

Objective To compare the effect of midcaudal combined approach and the cephalic middle approach in laparoscopic complete mesocolic excision (CME) in the treatment of right colon cancer complicated with incomplete intestinal obstruction. Methods From January 2014 to January 2019, 90 patients with right colon cancer complicated with incomplete intestinal obstruction admitted to the Third People′s Hospital of Dalian were retrospectively analyzed.All patients underwent laparoscopic right hemicolectomy, CME plus D3 lymph node dissection.According to the choice of different surgical approaches, 44 patients were treated with the midcaudal combined approach (observation group) and the other 46 patients were treated with cephalic middle approach (control group). The intraoperative, postoperative and complications of the two groups were compared statistically. Results Compared with the control group, the bleeding volume in the observation group was significantly reduced ((105.3±22.6) ml vs.(309.6±28.0) ml, t=13.698), the operation time was significantly shortened ((165.2±17.9) min vs.(219.5±21.5) min, t=8.327), and the differences were statistically significant (all P 0.05). Conclusion It is safe and feasible to use the middle caudal approach in laparoscopic CME for right colon cancer complicated with incomplete ileus. Compared with the cephalic middle approach, it can reduce thebleeding volume and shorten the operation time. Key words: Right colon cancer; Incomplete intestinal obstruction; Complete mesocolon resection; Midcaudal combined approach

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来源期刊

中国综合临床

CiteScore

0.10

自引率

0.00%

发文量

16855

期刊介绍： Clinical Medicine of China is an academic journal organized by the Chinese Medical Association (CMA), which mainly publishes original research papers, reviews and commentaries in the field. Clinical Medicine of China is a source journal of Peking University (2000 and 2004 editions), a core journal of Chinese science and technology, an academic journal of RCCSE China Core (Extended Edition), and has been published in Chemical Abstracts of the United States (CA), Abstracts Journal of Russia (AJ), Chinese Core Journals (Selection) Database, Chinese Science and Technology Materials Directory, Wanfang Database, China Academic Journal Database, JST Japan Science and Technology Agency Database (Japanese) (2018) and other databases.