腹腔镜完整系膜切除术治疗右半结肠癌的手术路径和临床效果分析
[摘要] 目的 觀察基于3个外科平面手术路径在腹腔镜完整系膜切除术治疗右半结肠癌中的应用，评价其临床效果。方法 以2012年1月—2016年12月为研究时间段，选取该院收治的25例右半结肠癌患者为研究对象，依据建档顺序分为对照组（2012年1月—2014年12月）10例行常规结肠癌根治术，研究组（2015年1月—2016年12月）15例行基于3个外科平面手术路径在腹腔镜完整系膜切除术，总结比较两组患者临床治疗效果。结果 研究组术中出血量（54.6±6.4）mL、住院时间（10.1±2.2）d、淋巴结清扫数（22.7±4.6）枚明显优于对照组（89.6±8.4）mL、（13.5±2.7）d、（15.9±4.2）枚，差异有统计学意义（P<0.05）；研究组与对照组治疗后切口感染（6.7% vs 10.0%）、肠梗阻（0.0% vs 10.0%）等并发症发生率差异无统计学意义（P>0.05）；研究组术后6个月复发率（6.7%）明显低于对照组（20.0%）（P<0.05）；经对两组患者为期6个月的随访中，两组患者生活质量各维度评分较之治疗前明显提升，且研究组提升效果明显高于对照组，差异有统计学意义（P<0.05）。结论 基于3个外科平面手术路径应用于腹腔镜完整系膜切除术治疗右半结肠癌中疗效确切，有助于降低患者术中出血量，减少住院时间，提升淋巴结清扫数目，改善患者生活质量评分，具有较高临床应用价值。
[关键词] 基于3个外科平面手术路径；腹腔镜完整系膜切除术；右半结肠癌；疗效
[中图分类号] R735 [文献标识码] A [文章编号] 1674-0742（2018）01（c）-0052-04
[Abstract] Objective This paper tries to observe the application of three surgical approaches in laparoscopic total mesorectal excision for the treatment of right colon cancer， and to evaluate its clinical effect. Methods 25 cases of right colon cancer patients from January 2012 to December 2016 admitted to the hospital were selected as the research objects， according to the filing order， they were divided into control group（January 2012 - December 2014） and 10 cases underwent radical nephrectomy with conventional colon cancer； and the study group（January 2015 - December 2016）， 15 cases based on three surgical operation path in the plane laparoscopic complete mesocolic excision， summarized and compared the clinical effect of two groups. Results The hemorrhage in the study group was （54.6±6.4）mL， hospitalization time （10.1±2.2）d， lymph nodes （22.7±4.6）， significantly better than the control group of （89.6±8.4）mL， （13.5±2.7）d， （15.9±4.2）， the difference was statistically significant （P<0.05）； the study group and control group after treatment of wound infection （6.7% vs 10.0%）， intestinal obstruction （0.0% vs 10.0%） no significant difference in complication rate（P>0.05）； the rate of recurrence of 6 months after operation in study group was significantly lower than the control group（6.7% vs 20.0%）（P<0.05）； the two patients were followed up for 6 months， two groups of patients with various dimensions of quality of life scores were improved more significantly than before treatment， and improvement of study group was significantly higher than the control group， the difference was statistically significant（P<0.05）. Conclusion Three surgical plane surgical approaches used in laparoscopic resection of complete mesocolic in treatment of colorectal cancer is exact， helping to reduce blood loss， reducing hospitalization time， increasing the number of lymph node dissection， improving patient quality of life score， and has high clinical application value.