比较网膜囊入路与中间入路腹腔镜左半结肠癌根治术的治疗效果。

回顾性分析2018年1月至2023年1月117例左半结肠癌患者临床资料，根据手术入路不同分为研究组（n=59例，采用网膜囊入路腹腔镜左半结肠癌根治术）与对照组（n=58例，采用中间入路腹腔镜左半结肠癌根治术）。数据采用SPSS 25.0软件进行统计学分析。临床指标等计量资料用（）表示，采用独立样本t检验；并发症等计数资料用[例（%）]表示，采用χ²检验；使用Kaplan-Meier曲线分析患者的生存情况。P<0.05为差异有统计学意义。

研究组患者腹腔镜游离时间短于对照组（P<0.05）；两组其他临床指标比较，差异无统计学意义（P>0.05）。研究组患者进入胰腺后方间隙次数明显少于对照组（P<0.05）；两组患者术中各种损伤的发生率和两组患者术前、手术结束即刻肠腔、腹腔癌细胞脱落率比较，差异均无统计学意义（P>0.05）。两组患者随访8~24个月，生存期比较差异无统计学意义（Log-Rank χ²=0.411，P=0.522）。

网膜囊入路在腹腔镜左半结肠癌根治术中可获得与中间入路相当的治疗效果，且能缩短腹腔镜游离时间、减少进入胰腺后方间隙次数。

To explore the application value and feasibility of expanding retrogastric space in obese patients undergoing laparoscopic radical gastrectomy (LPG) for proximal gastric cancer.

The clinical data of 117 patients with left semicolon carcinoma from January 2018 to January 2023 were retrospectively analyzed, and they were divided into study group (n=59 cases, laparoscopic radical resection of left semicolon carcinoma through omental sac approach) and control group (n=58 cases, laparoscopic radical resection of left semicolon carcinoma through intermediate approach) according to different surgical approaches. SPSS 25.0 software was used for statistical analysis. Clinical indicators and other measurement data were represented by (), and independent sample t test was used; The statistical data of complications were expressed by [cases (%)] and χ² test was used. Survival was analyzed using Kaplan-Meier curves. P < 0.05 was considered statistically significant.

The laparoscopic free time of the study group was shorter than that of the control group (P<0.05). There was no statistical significant difference in other clinical indicators between the two groups (P>0.05). The number of patients entering the posterior space of the pancreas in the study group was significantly less than that in the control group (P<0.05). There was no statistical significant difference in the incidence of various injuries during operation and the shedding rate of cancer cells in intestinal cavity and abdominal cavity before and immediately after operation between the two groups (P>0.05). There was no statistical significant difference in survival time between the two groups (Log-Rank χ²=0.411, P=0.522).

The retinal capsule approach can achieve the same therapeutic effect as the middle approach in laparoscopic radical resection of left colon cancer, and can shorten the laparoscopic free time and reduce the number of times of entering the posterior pancreatic space.