Clinical effect of 3D laparoscopic CME for right colon cancer in patients with preoperative CT imaging vascular variation

doi:10.3877/cma.j.issn.1674-3946.2022.04.022

Abstract

Abstract:

Objective

To investigate the clinical effect of 3D laparoscopic complete mesenteric resection（CME）for right colon cancer patients with preoperative CT imaging showing vascular variation.

Methods

The clinical data of 95 patients who underwent laparoscopic CME treatment of right colon cancer from December 2018 to July 2020 were retrospectively analyzed. The patients were divided into the 3D group（n=44 cases）and the 2D group（n=51 cases）according to different surgical methods. 3D group was underwent 3D laparoscopic CME for right colon cancer；Group 2D was received 2D laparoscopic CME for right colon cancer. SPSS 22.0 statistical software was used for data analysis. Perioperative indicators and inflammatory indicators were expressed as（

x ˉ

±s）and independent sample t test was used. Repeated measures ANOVA was used for measurement data at different times. Postoperative complications were counted by χ² or Fisher’s exact test. P<0.05 was considered statistically significant.

Results

The operative time，intraoperative blood loss，lymph node dissection time and hospital stay in 3D group were shorter than those in 2D group（P<0.05）. There was no significant difference in the number of dissected lymph nodes between 2 groups（P>0.05）. There was no statistical significance in the total incidence of postoperative complications between the two groups（P>0.05）. The blood WBC of the 3D group was lower than that of the 2D group at 3，5 d after surgery，and the blood IL-6，TNF-α and CRP were lower than that of the 2D group at 1，3and 5 days after surgery，and the differences were statistically significant（P<0.05）.

Conclusion

For patients with vascular variation shown by preoperative CT imaging，3D laparoscopic CME for right colon cancer can shorten the operation time，reduce intraoperative blood loss，shorten the length of hospital stay and faster postoperative recovery，which is a safe and reliable operation.

Key words: Colonic neoplasms, Laparoscopes, Complete mesocolic excision, Vascular variation

Yuqiang Xie, Dan Zhuang, Xihan Lin. Clinical effect of 3D laparoscopic CME for right colon cancer in patients with preoperative CT imaging vascular variation[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(04): 431-434.

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References 16

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组别	例	性别	年龄（岁）	BMI（kg/m²）	肿瘤部位	TNM分期
组别	例	男/女	年龄（岁）	BMI（kg/m²）	a/b/c	Ⅰ/Ⅱ/Ⅲ
3D组	44	31/13	58.3±7.6	24.1±2.6	12/24/8	4/28/12
2D组	51	38/13	57.6±8.0	23.9±2.4	15/29/7	7/33/11
Z/t/χ²		0.195	0.435	0.390	0.358	-0.845
P		0.658	0.664	0.678	0.836	0.398

组别	例	性别	年龄（岁）	BMI（kg/m²）	肿瘤部位	TNM分期
组别	例	男/女	年龄（岁）	BMI（kg/m²）	a/b/c	Ⅰ/Ⅱ/Ⅲ
3D组	44	31/13	58.3±7.6	24.1±2.6	12/24/8	4/28/12
2D组	51	38/13	57.6±8.0	23.9±2.4	15/29/7	7/33/11
Z/t/χ²		0.195	0.435	0.390	0.358	-0.845
P		0.658	0.664	0.678	0.836	0.398

组别	例	手术时间(min)	术中出血量(ml)	淋巴结清扫数目(枚)
3D组	44	196.5±23.7	159.2±19.8	25.6±8.3
2D组	51	216.3±28.8	180.8±16.4	24.5±7.5
t		3.623	5.815	0.678
P		0.000	0.000	0.499
组别	例	淋巴结清扫时间(min)	住院时间(d)	住院费用(万元)
3D组	44	31.7±5.2	9.2±1.5	3.1±0.3
2D组	51	42.2±4.3	10.8±1.7	3.2±0.4
t		10.772	4.828	1.360
P		0.000	0.000	0.177

组别	例	手术时间(min)	术中出血量(ml)	淋巴结清扫数目(枚)
3D组	44	196.5±23.7	159.2±19.8	25.6±8.3
2D组	51	216.3±28.8	180.8±16.4	24.5±7.5
t		3.623	5.815	0.678
P		0.000	0.000	0.499
组别	例	淋巴结清扫时间(min)	住院时间(d)	住院费用(万元)
3D组	44	31.7±5.2	9.2±1.5	3.1±0.3
2D组	51	42.2±4.3	10.8±1.7	3.2±0.4
t		10.772	4.828	1.360
P		0.000	0.000	0.177

组别	例	切口感染	吻合口漏	吻合口出血	肠梗阻	总并发症
3D组	44	1(2.2)	1(2.2)	0(0.0)	0(0.0)	2（4.5）
2D组	51	1(2.0)	2(3.9)	2(3.9)	1(2.0)	6(11.8)
χ²		-	-	-	-	0.797
P		-	-	-	-	0.372

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