全腹腔镜下无腹部辅助切口在乙状结肠及高位直肠肿瘤手术中的应用

摘要

Objective To evaluate the clinical value of total laparoscopic radical resection of colorectal cancer and high rectal cancer without abdominal auxiliary incision .Methods Thirty patients diagnosed as sigmoid colon cancer or high rectal cancer underwent laparoscopic surgery were randomly di -vided into control group and observation group.The patients in observation group were treated by total laparoscopy without abdominal incision , while the control group was treated by routine surgery with lower abdominal incision.The intro-operative indexes, postoperative short-term indexes and pathological results were compared.Results There was no significant difference in the operation time or the amount of blood loss during the operation between the two groups (P＞0.05).There was no significant difference in the incidence of postoperative complications or the cost of operation between the two groups ( P＞0.05).The time of hospitalization in the observation group was significantly shorter than that in the control group ( P＝0.003).There was no significant difference in the distance between the distal margin of the cutting edge or the number of lymph node dissection between the two groups ( P＞0.05).Conclusions Total laparoscopic radical resection of colon cancer and high rectal cancer without abdominal auxiliary incision is safe and effective , with less trauma and faster postoperative recovery , and does not increase the eco-nomic burden of patients.%目的 评估全腹腔镜下无腹部辅助切口在乙状结肠及高位直肠肿瘤手术的临床应用价值.方法 选取医院确诊为乙状结肠癌或高位直肠癌并接受腹腔镜手术治疗的患者30例,随机分为对照组和观察组.观察组患者采取全腔镜下无腹部辅助切口法;对照组则采取常规下腹部辅助小切口法.比较两组患者术中指标、术后短期指标和肿瘤标本病理结果.结果 两组患者手术时间和术中失血量比较,差异未见统计学意义(P＞0.05).两组患者术后并发症发生率及手术费用比较差异未见统计学意义(P＞0.05).观察组住院时间显著短于对照组(P＝0.003).两组患者远端切缘距离和淋巴结清扫数目比较差异未见统计学意义( P＞0.05).结论 全腹腔镜下无腹部辅助切口行乙状结肠及高位直肠肿瘤手术安全、有效,创伤小、术后恢复快,且不增加患者的经济负担,值得临床进一步推广.