摘要
目的探讨腹腔镜完整结肠系膜切除术治疗结肠癌的效果。方法选取2015年9月—2019年11月湖北省监利市第五人民医院收治的88例结肠癌患者作为研究对象,采用随机数字表法将其分为两组,每组各44例。对照组患者采用开腹手术,研究组患者采用腹腔镜完整结肠系膜切除术。比较两组患者的围术期指标、术后病理结果、并发症发生情况及随访结果。结果研究组患者的手术时间为(159.84±20.33)min,长于对照组的(142.06±23.64)min,差异有统计学意义(P<0.05);研究组患者的术中出血量为(87.93±15.05)mL,术后引流量为(194.85±60.19)mL,均少于对照组的(220.64±34.39)、(310.58±65.38)mL,差异有统计学意义(P<0.05);研究组患者的住院时间为(13.81±4.92)d,短于对照组的(16.98±6.33)d,差异有统计学意义(P<0.05);研究组患者的肛门排气时间为(3.16±0.85)h,对照组为(3.34±0.81)h,两组患者的肛门排气时间比较,差异无统计学意义(P>0.05);研究组患者的淋巴结清扫数为(21.89±4.63)枚,多于对照组的(18.17±2.94)枚,差异有统计学意义(P<0.05);研究组患者的肿瘤直径为(4.18±1.12)cm,对照组为(4.22±1.25)cm,两组患者的肿瘤直径比较,差异无统计学意义(P>0.05);研究组患者的淋巴结转移数为(4.52±0.61)枚,对照组为(4.71±0.63)枚,两组患者的淋巴结转移数比较,差异无统计学意义(P>0.05);研究组患者的并发症总发生率为4.55%,低于对照组的20.45%,差异有统计学意义(P<0.05);研究组患者的复发率为4.55%,转移率为2.27%,死亡率为0%。对照组为9.09%、6.82%、2.27%,两组患者的复发率、转移率、死亡率比较,差异无统计学意义(P>0.05)。结论采用腹腔镜完整结肠系膜切除术治疗结肠癌,具有创伤小、出血量少、并发症及复发率低的优点,可获得较好的肿瘤根除效果,对改善患者预后具有重要作用,值得临床推广应用。
Objective To explore the effect of laparoscopic complete mesocolectomy in the treatment of colon cancer.Methods Eighty-eight colon cancer patients admitted to the Fifth People′s Hospital of Jianli City,Hubei Province from September 2015 to November 2019 were selected as subjects.The patients were divided into two groups by random number table method,with 44 patients in each group.The control group underwent open surgery,and the study group underwent laparoscopic complete mesocolectomy.The perioperative indicators,postoperative pathological results,complications and follow-up results were compared between the two groups.Results The operation time of the study group was(159.84±20.33)min,longer than that of the control group of(142.06±23.64)min,the difference was statistically significant(P<0.05).The intraoperative blood loss and postoperative drainage in the study group were(87.93±15.05)mL and(194.85±60.19)mL,both were lower than those in the control group of(220.64±34.39)and(310.58±65.38)mL,with statistical significances(P<0.05).The length of hospital stay in the study group was(13.81±4.92)d,shorter than that in the control group of(16.98±6.33)d,and the difference was statistically significant(P<0.05).The anal exhaust time was(3.16±0.85)h in the study group and(3.34±0.81)h in the control group.There was no significant difference in the anal exhaust time between the two groups(P>0.05).The number of lymph node dissection in the study group was(21.89±4.63),which was higher than that in the control group of(18.17±2.94),and the difference was statistically significant(P<0.05).The tumor diameter was(4.18±1.12)cm in the study group and(4.22±1.25)cm in the control group.There was no statistical significance in the tumor diameter between the two groups(P>0.05).The number of lymph node metastasis was(4.52±0.61)in the study group and(4.71±0.63)in the control group.There was no significant difference in the number of lymph node metastasis between the two groups(P>0.05).The total incidence of complications in the study group was 4.55%,which was lower than that in the control group(20.45%),the difference was statistically significant(P<0.05).The recurrence rate,metastasis rate and mortality rate in the study group were 4.55%,2.27%and 0%,respectively,while those in the control group were 9.09%,6.82%and 2.27%.There were no significant differences in the recurrence rate,metastasis rate and mortality between the two groups(P>0.05).Conclusion The use of laparoscopic complete mesocolectomy for the treatment of colon cancer has the advantages of less trauma,less bleeding,low complications and low recurrence rate,and can achieve good tumor eradication effect.It plays an important role in improving the prognosis of patients,and is worthy of clinical application.
作者
罗剑
何文法
LUO Jian;HE Wen-fa(Department of Surgery,the Fifth People′s Hospital of Jianli City,Hubei Province,Jianli433300,China;The Second Department of Surgery,Jianli People′s Hospital,Hubei Province,Jianli433300,China)
出处
《中国当代医药》
CAS
2021年第23期120-123,共4页
China Modern Medicine
关键词
结肠癌
腹腔镜手术
完整结肠系膜切除术
围术期指标
并发症
Colon cancer
Laparoscopic surgery
Complete mesocolectomy
Perioperative indicators
Complications
