改良中线入路右半结肠切除术临床疗效观察

摘要

目的 探讨改良中线入路在右半结肠切除术中的应用及意义.方法 对2008年5月～2010年11月60例采用改良的中线人路右半结肠切除(改良术式组)患者资料进行回顾性分析,并与同期47例传统术式患者及71例中线人路术式患者相比较.结果 改良术式组第三站淋巴结清扫数平均2.5个,传统术式组第三站淋巴结清扫平均1.2个,中线入路术式组第三站淋巴结清扫平均2.6个,改良术式组清扫第三站淋巴结效果和中线入路组相当(P=0.693),两组均高于传统术式(P值分别为0.044,0.038),差异具有统计学意义;改良术式组平均手术时间46.3min,传统术式组组平均手术时间48.2min,中线入路组平均手术时间65.9min,改良术式组平均手术时间和传统术式组相当(P=0.788),两组均低于中线入路组(P值分别为0.039,0.046),差异具有统计学意义;3组平均出血量及术后平均引流量相当;本组病例无吻合口瘘发生.结论 改良中线入路右半结肠切除术能够安全的、彻底的清除肠系膜根部淋巴结,同时降低右半结肠切除术的难度.%Objective To study the effect of improved anterograde clearance lymph nods for right hemicolectomy.Methods Sixty patients who received modified right hemicolectomy form May 2008 to Nov 2009 were studied and compared with 47 cases who received operation with retrograde clearance lymph nods and 71 cases with anterograde clearance of lymph nods.Results D3 lymph nodes; the improved anterograde group was 2.5 , the anterograde group were 2.6 , the retrograde group were 1.2.The average time of operation : the improved anterograde group was 46.3 min, the retrograde group was 48.2 min, the anterograde group was 65.9 min.The improved anterograde group had more D3 group lymph nodes than retrograde group( P = 0.044 ) , while had less operation time than anterograde group ( P =0.039) .The average amount of bleeding had no difference among this three groups.Conclusion This improved retrograde clearance lymph nods for right hemicolectomy is superior than routine way.