切换至 "中华医学电子期刊资源库"

中华普外科手术学杂志(电子版) ›› 2019, Vol. 13 ›› Issue (04) : 382 -384. doi: 10.3877/cma.j.issn.1674-3946.2019.04.019

所属专题: 文献

论著

尾侧入路与中间入路行腹腔镜下右半结肠癌根治术临床效果对比
余志清1, 杜江2,()   
  1. 1. 638500 四川省邻水人民医院普通外科
    2. 621900 四川省科学城医院胃肠外科
  • 收稿日期:2018-10-26 出版日期:2019-08-26
  • 通信作者: 杜江

Clinical comparison of laparoscopic radical resection of right colon cancer with caudal approach and intermediate approach

Zhiqing Yu1, Jiang Du2,()   

  1. 1. General surgery of the people’s Hospital of neighboring Shui county, Sichuan 638500
    2. Gastrointestinal surgery, Science City Hospital, Sichuan Province 621900
  • Received:2018-10-26 Published:2019-08-26
  • Corresponding author: Jiang Du
  • About author:
    Corresponding author: Du Jiang, Email:
  • Supported by:
    Science and technology project of Mianyang city, Sichuan province(150023700145)
引用本文:

余志清, 杜江. 尾侧入路与中间入路行腹腔镜下右半结肠癌根治术临床效果对比[J]. 中华普外科手术学杂志(电子版), 2019, 13(04): 382-384.

Zhiqing Yu, Jiang Du. Clinical comparison of laparoscopic radical resection of right colon cancer with caudal approach and intermediate approach[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(04): 382-384.

目的

分析尾侧入路法与中央入路法在腹腔镜下右半结肠癌根治术中临床效果。

方法

回顾性分析2016年5月至2018年7月115例行腹腔镜右半结肠癌根治术患者资料,按手术入路不同分为观察组(n=57,采用尾侧入路)和对照组(n=58,采用中间入路)。数据采用SPSS 22.0统计软件分析,围术期各项指标以(±s)表示,采用独立t检验;并发症发生率采用χ2检验,以P<0.05为差异有统计学意义。

结果

观察组患者手术时间、术中出血量均少于对照组(P<0.05);两组患者淋巴结清扫数目、中转开腹率、术后恢复排气时间、排便恢复时间、拔除引流管时间、初次饮食时间、术后住院时间、术后并发症发生率差异均无统计学意义(P>0.05)。

结论

尾侧入路法在右半结肠癌根治术中具有手术时间短及术中出血量少优势,两种术式治疗右半结肠癌均安全、可靠。

Objective

To compare and analyze the clinical effect of two kind of approaches: caudal approach and central approach in laparoscopic radical resection of right colon cancer.

Methods

The data of 115 patients undergoing laparoscopic radical resection of right colon cancer from May 2016 to July 2018 were retrospectively analyzed. According to the different operative approaches, the patients were divided into two groups: the observation group(n=57 caudal approach was used) and the control group(n=58, central approach was used). The data were analyzed by SPSS 22.0 software. The measurement data of perioperative indexes were expressed as(±s), t test of independent samples was used between groups, the incidence of complications and other counting data were compared by χ2 test. P<0.05 meant the difference was statistically significant (P<0.05).

Results

The time of operation and the amount of intraoperative bleeding in the observation group were less than those in the control group (P<0.05); There was no significant difference in the number of lymph node dissection, the rate of conversion to laparotomy, the time of recovery of exhaust, the time of recovery of defecation, the time of removing drainage tube, the time of first eating, the time of hospitalization after operation, the incidence of postoperative complications (P>0.05).

Conclusion

The caudal approach has the advantages of short operative time and less blood loss during radical resection of right hemicolon cancer. Both methods are safe and reliable in the treatment of right hemicolon carcinoma.

表1 115例行右半结肠癌根治切除术患者不同入路两组一般资料比较[例,x±s]
表2 115例行右半结肠癌根治术患者不同入路两组患者术中情况比较(±s)
表3 115例行右半结肠癌根治术患者不同入路两组患者术后情况比较(±s)
表4 115例行右半结肠癌根治术患者不同入路两组术后并发症发生率比较[例(%)]
[1]
张忠涛,杨盈赤.腹腔镜直肠癌根治术难点与争议[J/CD].中华普外科手术学杂志(电子版),2018,12(1):1-4.
[2]
Matsuda T, Iwasaki T, Sumi Y, et al. Laparoscopic complete mesocolic excision for right-sided colon cancer using a cranial approach: anatomical and embryological consideration[J]. International Journal of Colorectal Disease,2017,32(1):139-141.
[3]
Wang Y, Huang D, Chen KY, et al. Fucosylation Deficiency in Mice Leads to Colitis and Adenocarcinoma[J]. Gastroenterology,2017,152(1):193-205.
[4]
Pedamallu CS, Bhatt AS, Bullman S, et al. Metagenomic Characterization of Microbial Communities In Situ Within the Deeper Layers of the Ileum in Crohn’s Disease[J]. Cell Mol Gastroenterol Hepatol,2016,2(5):563-566.
[5]
史自强.腹腔镜全结肠系膜切除术治疗右半结肠癌患者的效果分析[J].河南医学研究,2018,27(13):2411-2412.
[6]
Stoffel EM, Erichsen R, Froslev T, et al. Clinical and Molecular Characteristics of Post-Colonoscopy Colorectal Cancer: A Population-based Study[J]. Gastroenterology,2016,151(5):870-878.
[7]
Cannistra M, Ruggiero M, Grande R, et al. The impact of BMI on early colorectal neoplastic lesions and the role of endoscopic diagnosis. An Italian observational study[J]. Int J Surg,2016,33(Suppl 1):S71-S75.
[8]
隋文哲,陈军.CME理念在腹腔镜右半结肠癌根治术中的应用[J].医学综述,2018,24(20):3999-4003.
[9]
Ruiz-Rebollo ML, del Olmo-Martínez L, Velayos-Jiménez B, et al. Etiología y prevalencia de los cánceres colorrectales poscolonoscopia[J]. Gastroenterol Hepatol,2016,39(10):647-655.
[10]
Zhang BY, Jones JC, Briggler AM, et al. Lack of Caudal-Type Homeobox Transcription Factor 2 Expression as a Prognostic Biomarker in Metastatic Colorectal Cancer[J]. Clinical Colorectal Cancer,2017,16(2):124-128.
[11]
Gervaz P, Usel M, Rapiti E, et al. Right colon cancer: Left behind[J]. Eur Journal Surg Oncol,2016,42(9):1343-1349.
[12]
何平.尾侧腹侧入路法在腹腔镜右半结肠癌根治术中的应用[J].医学理论与实践,2018,31(14):2115-2117.
[13]
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):19-21,24.
[14]
叶进军,辛乐,刘继东,等.尾侧入路法腹腔镜右半结肠癌根治性切除术的临床体会[J].腹腔镜外科杂志,2018,23(3):170-174.
[15]
刘延锋,董昌利,王铎.腹腔镜右半结肠癌根治术的疗效及对患者炎症水平的影响[J/CD].中华普外科手术学杂志(电子版),2018,12(3):201-203.
[1] 黄来明, 张旭东. 雾化吸入布地奈德混悬液联合气管导管涂抹达克罗宁胶浆对改善妇科腹腔镜手术气管插管全身麻醉患者咽喉部不适作用[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 480-486.
[2] 李志伟, 向琪, 彭胜男, 郭玲, 孙贱根, 杨川. 右美托咪定与曲马多分别复合罗哌卡因在全麻下结肠癌根治术中的应用[J]. 中华普通外科学文献(电子版), 2023, 17(03): 182-185.
[3] 燕速, 霍博文, 徐惠宁. 4K荧光腹腔镜扩大右半结肠CME+D3根治术及No.206、No.204组淋巴结清扫术[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 14-14.
[4] 姚宏伟, 魏鹏宇, 高加勒, 张忠涛. 不断提高腹腔镜右半结肠癌D3根治术的规范化[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 1-4.
[5] 杜晓辉, 崔建新. 腹腔镜右半结肠癌D3根治术淋巴结清扫范围与策略[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 5-8.
[6] 周岩冰, 刘晓东. 腹腔镜右半结肠癌D3根治术消化道吻合重建方式的选择[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 9-13.
[7] 郑民华, 马君俊. 不断推进中国腹腔镜直肠癌手术规范化[J]. 中华普外科手术学杂志(电子版), 2023, 17(05): 473-476.
[8] 常剑, 邱峰, 毛郁琪. 摄食抑制因子-1与腹腔镜结直肠癌根治术后肝转移的关系分析[J]. 中华普外科手术学杂志(电子版), 2023, 17(05): 502-505.
[9] 徐伯麒, 陶亮, 章帆, 毛忠琦. 结肠癌患者淋巴结转移预测模型的建立[J]. 中华普外科手术学杂志(电子版), 2023, 17(04): 393-397.
[10] 邰清亮, 施波, 侍新宇, 陈国梁, 陈俊杰, 武冠廷, 王索, 孙金兵, 顾闻, 叶建新, 何宋兵. 腹腔镜次全结肠切除术治疗顽固性慢传输型便秘的疗效分析[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 478-483.
[11] 蓝冰, 王怀明, 王辉, 马波. 局部晚期结肠癌膀胱浸润的研究进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 505-511.
[12] 侯文运, 刘恒昌, 窦利州, 陈海鹏, 郑朝旭, 王贵齐, 王锡山. 腹部无辅助切口内镜引导下取标本的腹腔镜辅助右半结肠癌根治术(保留回盲部)(附视频)[J]. 中华结直肠疾病电子杂志, 2023, 12(05): 436-440.
[13] 唐新, 刁德昌, 廖伟林, 林佳鑫, 汪佳豪, 李文娟, 谢嘉欣, 敖琳, 李洪明, 易小江, 卢新泉, 冯晓创. 保留神经的鞘外游离技术在腹腔镜右半结肠癌D3根治术中的近远期疗效分析:基于倾向性评分匹配的回顾性队列研究[J]. 中华结直肠疾病电子杂志, 2023, 12(05): 372-380.
[14] 陈润芝, 杨东梅, 徐慧婷. 信迪利单抗联合索凡替尼后线治疗MSS型BRAF突变的转移性结肠癌:个案报道并文献复习[J]. 中华结直肠疾病电子杂志, 2023, 12(05): 431-435.
[15] 周启阳, 何宋兵, 胡优, 陈昕, 周雨迪, 周晓俊. 第四代达芬奇机器人单孔加一腹腔镜全结肠切除术治疗慢传输型便秘一例(附视频)[J]. 中华结直肠疾病电子杂志, 2023, 12(04): 348-352.
阅读次数
全文


摘要