腹腔镜辅助右半结肠癌完整结肠系膜切除术安全性及近期疗效分析

摘要

Objective To investigate the safety and short-term effcet between laparoscopic and open complete mesocolic excision for right-hemi colon cancer.Methods The clinical data of 18 cases underwent laparoscopic complete mesocolic excision and 37 cases underwent open operation for right-hemi colon cancer from Oct,2010 to Oct,2014 were collected and retrospectively analyzed.Using SPSS 13.0 software package for analysis.Results All the operation were successfully completed.The mean oprative time of laparoscopic complete mesocolic excision group was longer than open operation group [(232.50 ± 55.91) vs.183.16 ± 35.55) min (P ＞0.05)],the mean postoperative hospital stay time and the mean time to first flatus of laparoscopic complete mesocolic excision group was slight shorterthanopenoperation group [(10.28±2.86) d vs.(13.30±3.01) d,(2.39±0.98) d vs.(3.95 ± 1.25) d (P ＜ 0.05)],and the mean blood loss of laparoscopic complete mesocolic excision group was less than open operation group[(95.56± 50.26) mL vs.(140.41 ± 98.10) mL (P ＜ 0.05)].But there was no significant difference in the number of cleared lymph nodes,operation quality assessment,the complication rates and the staging of tumour.Conclusion This study shows that laparoscopic complete mesocolic excision for righthemi colon cancer is safety,therefme laparoscopic complete mesocolic excision can be considered as one of the surgical treatment for right-hemi colon cancer.The short-term outcomes of laparoscopic complete mesocolic excision has no significant difference from open operation.%目的 探讨腹腔镜辅助与开腹右半结肠癌完整结肠系膜切除术的安全性及近期疗效的比较.方法 回顾性分析2010年10月-2014年10月由安庆市立医院肿瘤外科同一手术组医师完成的腹腔镜辅助右半结肠癌完整结肠系膜切除术18例与同期进行的开腹右半结肠癌手术37例患者的临床资料,采用SPSS 13.0统计软件包进行统计学分析.结果 所有手术均顺利完成,腹腔镜辅助组在手术时间(232.50±55.91) min明显长于开腹手术组(183.16 ±35.55) min,术后住院时间、术后通气时间上腹腔镜辅助组要短于开腹手术组,分别为(10.28±2.86)d vs(13.30±3.01)d,(2.39 ±0.98)d vs(3.95±1.25)d,P均＜0.05,在术中出血上腹腔镜辅助组要明显少于开腹手术组(95.56±50.26) mL vs(140.41±98.10) mL,P＜0.05,而两组间在手术质量评定、淋巴结清扫数目、术后并发症发生情况、及肿瘤的分级分期上无明显差异.结论 腹腔镜辅助右半结肠癌CME手术安全可行,可以作为右半结肠癌外科治疗的一种术式,在近期疗效上与开腹手术组无差异.