中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2014年
11期
1121-1124
,共4页
季福建%刘选文%刘卓%房学东
季福建%劉選文%劉卓%房學東
계복건%류선문%류탁%방학동
直肠肿瘤%直肠癌根治术%淋巴结清扫%闭孔淋巴结%三维成像系统%二维成像系统
直腸腫瘤%直腸癌根治術%淋巴結清掃%閉孔淋巴結%三維成像繫統%二維成像繫統
직장종류%직장암근치술%림파결청소%폐공림파결%삼유성상계통%이유성상계통
Rectal neoplasms%Colorectal cancer resection%Lymph node dissection%Obturator lymph nodes%Three-dimensional imaging system%Two-dimensional imaging system
目的 对比三维成像系统(3D)与二维成像系统(2D)在腹腔镜直肠癌深部闭孔淋巴结清扫手术中的应用情况.方法 回顾性分析2013年1月至2014年5月在吉林大学中日联谊医院新民院区接受腹腔镜下直肠癌根治性切除加闭孔淋巴结清扫的36例直肠癌患者的临床资料.其中16例在3D系统下完成(3D手术组),20例在传统2D系统下完成(2D手术组).比较两组闭孔淋巴结清扫完成的时间、手术总时间、淋巴结清扫总数、错抓次数(同一部位需要两次以上的定位才能正确抓取)和闭孔淋巴结清扫期间的出血量.结果 两组均顺利完成腹腔镜下直肠癌根治术,无中转开腹.3D手术组和2D手术组总手术时间分别为(206±26) min和(222.5±27.5) min(P＜0.05),闭孔淋巴结清扫时间分别为(23.5±2.5) min和(25.0±3.0) min(P＜0.05),错抓次数分别为(5±2)次和(6±4)次(P＜0.01),清扫闭孔淋巴结期间的出血量分别为(15.5±1.5) ml和(17.5±2.5) ml(P＜0.01),淋巴结清扫总数分别为(24±6)枚和(21±9)枚(P＜0.05).术后获1年随访者3D手术组有6例,2D手术组11例,均无肿瘤复发和死亡病例.结论 3D腹腔镜技术对于直肠癌闭孔淋巴结清扫较2D手术系统有明显优势,是一项值得推广的新技术.
目的 對比三維成像繫統(3D)與二維成像繫統(2D)在腹腔鏡直腸癌深部閉孔淋巴結清掃手術中的應用情況.方法 迴顧性分析2013年1月至2014年5月在吉林大學中日聯誼醫院新民院區接受腹腔鏡下直腸癌根治性切除加閉孔淋巴結清掃的36例直腸癌患者的臨床資料.其中16例在3D繫統下完成(3D手術組),20例在傳統2D繫統下完成(2D手術組).比較兩組閉孔淋巴結清掃完成的時間、手術總時間、淋巴結清掃總數、錯抓次數(同一部位需要兩次以上的定位纔能正確抓取)和閉孔淋巴結清掃期間的齣血量.結果 兩組均順利完成腹腔鏡下直腸癌根治術,無中轉開腹.3D手術組和2D手術組總手術時間分彆為(206±26) min和(222.5±27.5) min(P＜0.05),閉孔淋巴結清掃時間分彆為(23.5±2.5) min和(25.0±3.0) min(P＜0.05),錯抓次數分彆為(5±2)次和(6±4)次(P＜0.01),清掃閉孔淋巴結期間的齣血量分彆為(15.5±1.5) ml和(17.5±2.5) ml(P＜0.01),淋巴結清掃總數分彆為(24±6)枚和(21±9)枚(P＜0.05).術後穫1年隨訪者3D手術組有6例,2D手術組11例,均無腫瘤複髮和死亡病例.結論 3D腹腔鏡技術對于直腸癌閉孔淋巴結清掃較2D手術繫統有明顯優勢,是一項值得推廣的新技術.
목적 대비삼유성상계통(3D)여이유성상계통(2D)재복강경직장암심부폐공림파결청소수술중적응용정황.방법 회고성분석2013년1월지2014년5월재길림대학중일련의의원신민원구접수복강경하직장암근치성절제가폐공림파결청소적36례직장암환자적림상자료.기중16례재3D계통하완성(3D수술조),20례재전통2D계통하완성(2D수술조).비교량조폐공림파결청소완성적시간、수술총시간、림파결청소총수、착조차수(동일부위수요량차이상적정위재능정학조취)화폐공림파결청소기간적출혈량.결과 량조균순리완성복강경하직장암근치술,무중전개복.3D수술조화2D수술조총수술시간분별위(206±26) min화(222.5±27.5) min(P＜0.05),폐공림파결청소시간분별위(23.5±2.5) min화(25.0±3.0) min(P＜0.05),착조차수분별위(5±2)차화(6±4)차(P＜0.01),청소폐공림파결기간적출혈량분별위(15.5±1.5) ml화(17.5±2.5) ml(P＜0.01),림파결청소총수분별위(24±6)매화(21±9)매(P＜0.05).술후획1년수방자3D수술조유6례,2D수술조11례,균무종류복발화사망병례.결론 3D복강경기술대우직장암폐공림파결청소교2D수술계통유명현우세,시일항치득추엄적신기술.
Objective To compare the handling and efficacy between three-dimensional (3D) imaging system and two-dimensional (2D) imaging system for laparoscopic surgery of rectal cancer deep obturator lymph node dissection.Methods Clinical data of 36 patients who underwent rectal cancer resection and obturator lymph node dissection with 3D or 2D imaging system from January 2013 to May 2014 in our department were retrospectively analyzed.There were 16 cases and 20 cases in 3D group and 2D group respectively.Completion time of obturator lymph node dissection,total operation time,total number of lymph node dissected,number of wrong grasping (more than twice for correct positioning in the same site) times and blood loss during obturator lymph node dissection were compared between two groups.Result The laparoscopic rectal cancer resections were successfully completed without laparotomy in both groups.The completion time of obturator lymph node dissection was (23.5± 2.5) min and (25.0±3.0) min respectively (P＜0.05); the number of wrong grasping was 5.0±2.0 and 6.0±4.0 (P＜0.01); the blood loss during obturator lymph node dissection was (15.5±1.5) ml and (17.5±2.5) ml(P＜0.01).The differences were all statistically significant.The total operation time of 3D and 2D group was (206.0±26.0) min and (222.5±27.5) min (P＜0.05); the total number of lymph node dissected was 24±6 and 21±9 (P＜0.05).The differences were statistically significant as well.Six cases in 3D group and 11 cases in 2D group were followed up for 1 year and there was no tumor recurrence or death case.Conclusion 3D laparoscopic technique has more obvious advantages as compared with 2D laparoscopic system in rectal cancer deep obturator lymph node dissection,so it is worthy to spread.
