CAJ | 학술논문

目的探讨经脐单切口腹腔镜右半结肠切除术治疗右半结肠癌的可行性和临床疗效.方法回顾性分析15例经脐单切口腹腔镜右半结肠切除术(单切口组)与20例开腹右半结肠切除术(开腹组)患者的临床资料.结果单切口组切口长度、术中出血量、肛门排气时间、进食时间、住院时间明显优于开腹组[(5.5±0.6)cm比(17.6±2.2) cm、(84.0±31.1) ml比(155.5±43.1) ml、(2.00±0.76)d比(3.75±0.63)d、(5.3±0.6)d比(6.5±0.6)d、(9.3±1.4)d比(13.5±1.5)d],手术时间长于开腹组[(238.4±19.3) min比(165.3±25.8) min],差异有统计学意义(P＜0.05);两组淋巴结清除数量比较差异无统计学意义(P＞0.05).单切口组术后发生并发症2例,开腹组发生并发症3例,两组并发症发生情况比较差异无统计学意义(P＞0.05).随访1～55个月,中位随访28个月,单切口组局部复发和远处转移2例,开腹组4例,两组比较差异无统计学意义(P＞0.05).结论单切口腹腔镜右半结肠切除术治疗右半结肠癌是安全、可行的,具有微创、美观、出血少、恢复快、住院时间短等优势,可在有一定腹腔镜手术基础的医院施行.
목적 탐토경제단절구복강경우반결장절제술치료우반결장암적가행성화림상료효.방법 회고성분석15례경제단절구복강경우반결장절제술(단절구조)여20례개복우반결장절제술(개복조)환자적림상자료.결과 단절구조절구장도、술중출혈량、항문배기시간、진식시간、주원시간명현우우개복조[(5.5±0.6)cm비(17.6±2.2) cm、(84.0±31.1) ml비(155.5±43.1) ml、(2.00±0.76)d비(3.75±0.63)d、(5.3±0.6)d비(6.5±0.6)d、(9.3±1.4)d비(13.5±1.5)d],수술시간장우개복조[(238.4±19.3) min비(165.3±25.8) min],차이유통계학의의(P＜0.05);량조림파결청제수량비교차이무통계학의의(P＞0.05).단절구조술후발생병발증2례,개복조발생병발증3례,량조병발증발생정황비교차이무통계학의의(P＞0.05).수방1～55개월,중위수방28개월,단절구조국부복발화원처전이2례,개복조4례,량조비교차이무통계학의의(P＞0.05).결론 단절구복강경우반결장절제술치료우반결장암시안전、가행적,구유미창、미관、출혈소、회복쾌、주원시간단등우세,가재유일정복강경수술기출적의원시행.
Objective To study the feasibility and clinical effect of trans umbilical single incision laparoscopic right hemicolectomy for right hemicolon carcinoma.Methods The clinical data of 35 patients with right hemicolon carcinoma were retrospectively analyzed,the 15 cases were received the trans umbilical single incision laparoscopic right hemicolectomy (single incision group) and 20 cases were received laparotomy right hemicolectomy (laparotomy group).The clinical indexes were compared between the 2 groups.Results The length of incision,intraoperative bleeding volume,passage of gas by anus time,feeding time,hospitalized time in single incision group were significantly better than those in laparotomy group [(5.5 ± 0.6) cm vs.(17.6 ± 2.2) cm,(84.0 ± 31.1) ml vs.(155.5 ± 43.1) ml,(2.00 ± 0.76) d vs.(3.75 ± 0.63) d,(5.3 ± 0.6) d vs.(6.5 ± 0.6) d,(9.3 ± 1.4) d vs.(13.5 ± 1.5) d],the operation time in single incision group was significantly longer than that in laparotomy group [(238.4 ± 19.3) min vs.(165.3 ± 25.8) min],there were statistical differences (P ＜ 0.05).There was no statistical difference in number of incision lymph node between the 2 groups (P ＞ 0.05).Postoperative complication in single incision group occurred in 2 cases,postoperative complication in laparotomy group occurred in 3 cases,there was no statistical difference (P ＞0.05).The follow-up time was 1-55 months,the median follow-up time was 28 months,local recurrence and distant metastasis were found in 2 cases in single incision group,and 4 cases was found in laparotomy group,there was no statistical difference (P ＞ 0.05).Conclusions Single incision laparoscopic right hemicolectomy for right hemicolon carcinoma is safe and feasible,which has the advantages of minimal trauma,aesthetic outlook,less bleeding,quick recovery and short hospitalization time,etc.It can be developed in the hospital which has some basis of laparoscopic surgery.