3D腹腔镜在右半结肠癌根治术中的应用

摘要

目的 探讨3D高清腹腔镜在右半结肠癌根治术中的临床应用价值. 方法 回顾性分析2014年5月~2015年12月腹腔镜右半结肠全系膜切除术资料,3D高清腹腔镜(3D组)24例,2D高清腹腔镜(2D组)26例,对比2组在手术时间、术中出血量、淋巴结清扫数量、住院费用方面的差异. 结果 3D组手术时间为(126.7±4.5)min,2D组为(132.6±3.8)min,差异有统计学意义(t=5.171,P=0.000),但无临床意义,3D组术中失血量(62.5±12.2)ml,2D组(65.8±13.4)ml,无统计学差异(t=0.908,P=0.368);3D组淋巴结清扫数量(12.9±3.7)枚,2D组为(13.3±2.1)枚,差异无统计学意义(t=0.720,P=0.351);住院费用3D组(5.2±1.2)万元,2D组(5.0±1.3)万元,无统计学差异(t=0.564,P=0.575).2组术后无吻合口漏、腹腔感染和肠梗阻等重大并发症,均痊愈出院. 结论 3D高清腹腔镜能提供清晰的三维立体视觉,良好的深度感,可实现精确操作,同时淋巴结清扫效果相近.%Objective To investigate the clinical value of 3D high-resolution laparoscope in radical operation of right colon cancer.Methods The date of the patients receiving complete mesocolic excision from May 2014 to December 2015 were retrospectively analyzed.They were divided into two groups: 3D high-resolution laparoscope group (24 cases) and 2D high-resolution laparoscope group (26 cases).The differences in operative time, intraoperative blood loss, number of lymph nodes dissection, and hospitalization costs were compared between the two groups.Results The mean duration of surgery was (126.7±4.5) min in the 3D group and (132.6±3.8) min in the 2D group, with a statistically significant difference (t=5.171, P=0.000) but without clinical significance.The blood loss in the 3D group was (62.5±12.2) ml and in the 2D group was (65.8±13.4) ml, and the difference was not statistically significant (t=0.908, P=0.368).The number of lymph node dissection in the 3D group was (12.9±3.7) and in the 2D group was (13.3±2.1),without significant difference (t=0.720, P=0.351).The hospitalization costs were (5.2±1.2)×104 yuan in the 3D group and (5.0±1.3)×104 yuan in the 2D group and there was no statistically significant difference between the two groups (t=0.564, P=0.575).The major complications of postoperative anastomotic leakage, abdominal infection and intestinal obstruction in two groups were not found.The patients were all cured and discharged from the hospital.Conclusion 3D laparoscope can provide a clear 3D stereo vision and a good sense of depth, and also can achieve accurate operation, with a similar number of lymph nodes dissected.