目的

探讨头侧-中央混合入路腹腔镜根治术治疗右半结肠癌的治疗效果。

方法

回顾性收集2018年5月至2023年5月36例接受头侧-中央混合入路腹腔镜根治术治疗的右半结肠癌患者临床资料（混合组）；同期收集36例接受中央入路治疗患者临床资料（对照组）。采用SPSS 25.0统计学软件分析。术前、术中指标等计量资料以（）描述，行t检验；并发症等计数资料用［例（%）］描述，行χ²检验。Kaplan-Meier曲线分析生存情况。

结果

混合组术中出血量少于对照组，手术时间短于对照组（P<0.05）；两组淋巴结清扫数量比较，差异无统计学意义（P>0.05）。两组患者术后首次进食、首次排气等术后指标比较，差异无统计学意义（P>0.05）。混合组未出现中转开腹，对照组出现1例，中转开腹率比较，差异无统计学意义（P>0.05）。术后1周，两组患者胃泌素（GAS）、胃动素（MTL）水平均下降，差异有统计学意义（P<0.05）；但组间比较，差异无统计学意义（P>0.05）。术后1周，两组患者癌胚抗原（CEA）、糖类抗原199（CA199）、CA125水平均下降（P<0.05），但组间比较，差异无统计学意义（P>0.05）。两组并发症发生率比较，差异无统计学意义（P>0.05）。随访时间为6～12个月，中位随访时间为12个月。两组患者生存情况比较差异无统计学意义（Log-Rank χ²=0.765，P=0.382）。

结论

相较于中央入路，头侧-中央混合入路治疗右半结肠癌患者可获得与其相当的远期疗效，但其能有效缩短手术时间，降低术中出血量。

Objective

To explore the therapeutic effect of laparoscopic radical resection via the head-side and central mixed approach for right-sided colon cancer.

Methods

The clinical data of 36 patients with right-sided colon cancer who underwent laparoscopic radical resection via the head-side and central mixed approach from May 2018 to May 2023 were retrospectively collected (mixed group). At the same time, the clinical data of 36 patients who underwent the central approach were collected (control group). The statistical software SPSS 25.0 was used for analysis. Measurement data such as preoperative and intraoperative indexes were described by (), and t test was performed; Enumeration data such as complications were described by［ cases (%)］, and chi-square test was performed. The survival situation was analyzed by the Kaplan-Meier curve.

Results

The intraoperative blood loss in the mixed group was less than that in the control group, and the operation time was shorter than that in the control group (P<0.05). There was no significant difference in the number of lymph node dissections between the two groups (P>0.05). There were no significant differences in postoperative indexes such as the first meal intake and the first exhaust after surgery between the two groups(P>0.05). There was no conversion to open surgery in the mixed group, while there was 1 case in the control group. There was no significant difference in the conversion rate to open surgery between the two groups (P>0.05).One week after surgery, the levels of gastrin (GAS) and motilin (MTL) in both groups of patients decreased,and the differences were statistically significant (P<0.05); however, there was no significant difference between the two groups (P>0.05). One week after surgery, the levels of carcinoembryonic antigen (CEA),carbohydrate antigen 199 (CA199), and CA125 in both groups of patients decreased (P<0.05), but there was no significant difference between the two groups (P>0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). The follow-up period was 6 to 12 months, and the median follow-up period was 12 months. There was no significant difference in the survival situation between the two groups (Log-Rank χ²=0.765, P=0.382).

Conclusion

Compared with the central approach, the head-side and central mixed approach for patients with right-sided colon cancer can achieve a comparable long-term curative effect, but it can effectively shorten the operation time and reduce the intraoperative blood loss.