目的

探讨头尾侧联合入路腹腔镜右半结肠癌根治术的近中期疗效。

方法

回顾性分析2018年8月至2021年8月99例行腹腔镜根治术的右半结肠癌患者资料，根据入路不同分为头侧组（n=49例，行全头侧入路）和联合组（n=50例，行头尾侧联合入路）。采用SPSS 25.0软件处理数据，手术相关指标、术后恢复指标等计量资料以（± s）表示，采用独立样本t检验；并发症、生存率等计数资料用［例（%）］表示，采用χ²检验。P＜0.05为差异有统计学意义。

结果

联合组患者手术时间较头侧组短，术中出血量、术中血管损伤例数较头侧组少（P＜0.05）；两组患者术后首次排气时间、首次进食时间、拔除引流管时间和住院时间比较，差异无统计学意义（P＞0.05）；两组患者术中清扫淋巴结数目、术后并发症总发生率、术后2年总生存率比较，差异无统计学意义（P＞0.05）。

结论

相较于完全头侧入路，腹腔镜下结肠癌根治术经头尾侧联合入路能缩短手术时间、减少术中出血量、降低血管损伤风险，而完全头侧入路与头尾侧联合入路治疗结肠癌的安全性和近中期预后相当。

Objective

To investigate the short and medium term efficacy of laparoscopic radical resection of right half colon cancer by combined head and tail approach.

Method

Data of 99 patients with right half colon cancer who underwent laparoscopic radical resection from August 2018 to August 2021 were retrospectively analyzed, and divided into a cephalic group (n=49 cases, all cephalic approach) and a combined group (n=50 cases, combined cephalic and caudal approach) according to different approaches.SPSS 25.0 software was used to process the data.Measurement data such as surgery-related indicators and postoperative recovery indicators were represented by (x±s) and independent sample t test was used.The statistical data of complications and survival rate were expressed by［ cases (%)］ using χ² test.P＜0.05 was considered statistically significant.

Results

The operative time of the combined group was shorter than that of the cephalic group,and the number of intraoperative blood loss and vascular injury cases was lower than that of the cephalic group(P＜0.05).There was no significant difference in the time of first discharge, first feeding, drainage tube removal and hospital stay between the two groups (P＞0.05).There was no significant difference in the number of lymph nodes removed during operation, the total incidence of postoperative complications and the 2-year overall survival rate between the two groups (P＞0.05).

Conclusion

Compared with the complete cephalic approach,the combined cephalic and caudal laparoscopic radical resection of colon cancer can shorten the operation time,reduce the amount of intraoperative blood loss, and reduce the risk of vascular injury.The safety and nearmedium term prognosis of the combined cephalic and caudal approach for colon cancer are comparable.