Clinical effect of laparoscopic ileocecal right hemicolectomy in the treatment of right hemicolon carcinoma

doi:10.3877/cma.j.issn.1674-3946.2025.02.010.

Abstract

Abstract:

Objective

To investigate the therapeutic effect of laparoscopic radical resection of right hemicolonic carcinoma (LISH) with ileocecal area preserved in patients with right hemicolonic carcinoma.

Methods

Sixty patients with right half colon cancer between January 2021 and December 2023 were studied.They were divided into observation group (n=30) and control group (n=30) by random number table method.The observation group received LISH, and the control group received traditional laparoscopic radical right hemicolectomy (LRH).SPSS 27.0 software was used to analyze the data.Measurement data such as perioperative indicators were represented by (± s) and independent sample t test was performed.The incidence of postoperative complications was expressed as rate, and the counting data were tested by χ².The quality of life score before and after surgery was expressed as (x±s), and repeated measure ANOVA was used for comparison.P＜0.05 was considered statistically significant.

Results

There was no significant difference in operation time, intraoperative blood loss and hospital stay between the two groups (P＞0.05).The time of defecation, eating and exhaust in observation group was shorter than that in control group (P＜0.05).The incidence of postoperative complications in observation group was lower than that in control group (10.0% vs.33.3%, P＜0.05).There was no interaction between time and method on SF-36 quality of life score (P＞0.05).The main effect of time and method on SF-36 quality of life score was significant (P＜0.05).The SF-36 quality of life scores of both groups showed a gradually increasing trend at 3, 6 and 12 months after surgery, and the scores of patients in the observation group were higher than those in the control group at 3, 6 and 12 months after surgery (P＜0.05).

Conclusion

For patients with right colon cancer, the implementation of LISH to ensure the effect of radical tumor treatment can effectively reduce the time required for postoperative defecation, eating and exhaust, significantly reduce the incidence of complications, and improve the long-term postoperative quality of life of patients.

Key words: Right Hemicolonic Carcinoma, Right Hemicolectomy, Laparoscopes, Ileocecal Part

Keke He, Haiyang Gu, Shu Xiao, Qi Wei, Xinyu Li. Clinical effect of laparoscopic ileocecal right hemicolectomy in the treatment of right hemicolon carcinoma[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(02): 149-152.

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Figures/Tables 4

组别	例数	性别(例)	年龄（岁， $\overset{ˉ}{x}$ ±s）	TNM分期（例）
组别	例数	女/男	年龄（岁， $\overset{ˉ}{x}$ ±s）	Ⅰ/Ⅱ
观察组	30	27/33	51.37.6	17/43
对照组	30	22/38	51.56.5	23/37
χ ²/t/z值		0.862	0.155	1.350
P值		0.353	0.877	0.245
组别	例数	ASA分级（例）	病变类型（例）
组别	例数	Ⅰ/Ⅱ/Ⅲ	肝曲结肠癌/近端横结肠癌
观察组	30	34/24/2	37/23
对照组	30	32/27/1	34/26
χ ²/t/z值		0.370	0.310
P值		0.711	0.577

组别	例数	性别(例)	年龄（岁， $\overset{ˉ}{x}$ ±s）	TNM分期（例）
组别	例数	女/男	年龄（岁， $\overset{ˉ}{x}$ ±s）	Ⅰ/Ⅱ
观察组	30	27/33	51.37.6	17/43
对照组	30	22/38	51.56.5	23/37
χ ²/t/z值		0.862	0.155	1.350
P值		0.353	0.877	0.245
组别	例数	ASA分级（例）	病变类型（例）
组别	例数	Ⅰ/Ⅱ/Ⅲ	肝曲结肠癌/近端横结肠癌
观察组	30	34/24/2	37/23
对照组	30	32/27/1	34/26
χ ²/t/z值		0.370	0.310
P值		0.711	0.577

组别	例数	手术时间（min）	术中出血量（ml）	排便时间（d）
观察组	30	261.545.7	47.621.4	2.60.79
对照组	30	267.352.3	53.123.8	3.81.3
t值		0.647	1.331	6.110
P值		0.519	0.186	＜0.001
组别	例数	进食时间（d）	排气时间（d）	住院时间（d）
观察组	30	1.70.8	2.11.0	9.23.5
对照组	30	2.61.2	2.71.4	9.73.8
t值		4.834	2.701	0.750
P值		＜0.001	0.008	0.455

组别	例数	切口感染	腹泻	腹胀	腹腔粘连	肠粘连	总发生率（%）
观察组	30	1	0	1	1	0	3（10.0）
对照组	30	2	5	2	0	1	10（33.3）
χ ²值		-	-	-	-	-	4.812
P值		-	-	-	-	-	0.028

组别	例数	时间	一般健康	生理功能	生理角色
观察组	30	术后3个月	45.4±7.1	47.1±5.9	49.5±8.7
		术后6个月	61.8±6.1	59.9±5.3	57.6±4.8
		术后12个月	69.7±10.2	68.3±7.5	70.1±9.6
		术前	37.8±5.2	36.8±5.2	34.9±6.7
对照组	30	术后3个月	40.5±6.3	43.2±7.2	42.3±5.8
		术后6个月	49.2±5.9	46.2±6.0	48.1±5.2
		术后12个月	54.3±8.2	52.6±5.3	53.6±6.4
F值			F_时间=5.221，	F_时间=5.482，	F_时间=4.789，
			F_组间=3.942，	F_组间=5.038，	F_组间=4.396，
			F_交互=1.516	F_交互=1.496	F_交互=1.721
P值			P_时间=0.006，	P_时间=0.021，	P_时间=0.030，
			P_组间=0.024，	P_组间=0.032，	P_组间=0.038，
			P_交互=0.113	P_交互=0.529	P_交互=0.184

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