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中华普外科手术学杂志(电子版) ›› 2021, Vol. 15 ›› Issue (04) : 454 -456. doi: 10.3877/cma.j.issn.1674-3946.2021.04.028

论著

完全腹腔镜切除术治疗右半结肠癌的消化道重建方式选取研究
罗佳宝1,(), 邱堃1, 刘宁2, 吴元清1, 林杰1   
  1. 1. 572299 海南省第二人民医院普外科
    2. 570311 海南省人民医院胃肠一科
  • 收稿日期:2020-05-14 出版日期:2021-08-17
  • 通信作者: 罗佳宝

Selection of alimentary canal reconstruction methods for complete laparoscopic resection of right colon cancer

Jiabao Luo1,(), Kun Qiu1, Ning Liu2, Yuanqing Wu1, Jie Lin1   

  1. 1. The Second People’s Hospital Of Hainan Province, 572299
    2. Halnangeneral Hospital, Hainan Province, 570311
  • Received:2020-05-14 Published:2021-08-17
  • Corresponding author: Jiabao Luo
引用本文:

罗佳宝, 邱堃, 刘宁, 吴元清, 林杰. 完全腹腔镜切除术治疗右半结肠癌的消化道重建方式选取研究[J/OL]. 中华普外科手术学杂志(电子版), 2021, 15(04): 454-456.

Jiabao Luo, Kun Qiu, Ning Liu, Yuanqing Wu, Jie Lin. Selection of alimentary canal reconstruction methods for complete laparoscopic resection of right colon cancer[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(04): 454-456.

目的

探讨完全腹腔镜切除术治疗右半结肠癌的消化道重建方式选取。

方法

回顾性分析2018年10月至2019年11月89例右半结肠癌患者病例资料,根据术中消化道重建方式的不同分为改良组(43例)和重叠组(46例),改良组采用改良三角吻合法进行消化道重建,重叠组则采用重叠式三角吻合法进行消化道重建。采用SPSS 23.0统计分析软件,符合正态分布的手术相关指标、生活质量及预后营养指数以(±s)表示,采用独立样本t检验;并发症等计数资料采用χ2检验。P<0.05为差异有统计学意义。

结果

重叠组术中出血量、住院时间、术后并发症总发生率与改良组相比,差异无统计学意义(P>0.05)。重叠组吻合时间、手术时间、术后首次排气时间均比改良组短(P<0.05)。术后6个月两组胃肠道生存质量(GIQLI)、预后营养指数(PNI)相比,差异均无统计学意义(P>0.05)。

结论

重叠式三角吻合法在完全腹腔镜右半结肠癌切除术中可有效缩短术中吻合时间及手术时间,有助于降低手术风险,但在降低并发症、改善预后等方面无明显优势。

Objective

To explore the selection of digestive tract reconstruction methods in the treatment of right colon cancer by complete laparoscopic resection.

Methods

The data of 89 patients with right colon cancer from October 2018 to November 2019 were retrospectively analyzed. According to the different methods of intraoperative digestive tract reconstruction, the patients were divided into modified group (43 cases) and overlapping group (46 cases). The modified group used modified triangular anastomosis for digestive tract reconstruction, while the overlapping group used overlapping triangular anastomosis for digestive tract reconstruction. SPSS 23.0 software was used for statistical analysis. The surgically-related indicators, quality of life and prognostic nutrition index in accordance with the normal distribution are represented by (±s), and independent sample t test was used. Complications and other enumeration data were compared using χ2 test. P<0.05 was considered statistically significant.

Result

Compared with the modified group, the intraoperative blood loss, the length of hospitalization, and the total postoperative complication rate in the overlapping group were not significantly different (P>0.05). The anastomosis time, operation time and the first postoperative exhaust time in overlapping group were shorter than those in modified group (P< 0.05). There was no significant difference in gastrointestinal quality of life (GIQLI) and prognostic nutrition index (PNI) between the two groups 6 months after surgery (P>0.05).

Conclusion

The overlapping triangular anastomosis method can effectively shorten the anastomosis time and operation time in complete laparoscopic resection of right colon cancer, which helps to reduce the operation risk, but it has no obvious advantages in reducing complications and improving prognosis.

表1 89例右半结肠癌患者不同消化道重建方式两组基础性资料比较(±s)
表2 89例右半结肠癌患者不同消化道重建方式两组手术相关指标比较(±s)
表3 89例右半结肠癌患者不同消化道重建方式两组患者术后并发症比较(例)
表4 89例右半结肠癌患者不同消化道重建方式两组生活质量及预后营养指数比较(±s)
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