中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2015年
8期
693-696
,共4页
姚旭%何静妮%田忠%刘源
姚旭%何靜妮%田忠%劉源
요욱%하정니%전충%류원
右半结肠癌根治术%手助腹腔镜%全腹腔镜%疼痛评分%美容评分
右半結腸癌根治術%手助腹腔鏡%全腹腔鏡%疼痛評分%美容評分
우반결장암근치술%수조복강경%전복강경%동통평분%미용평분
Radical right colectomy%Hand-assistant laparoscopy%Total laparoscopy%Pain score%Cosmetic satisfactory score
目的 探讨采用手助腹腔镜与全腹腔镜右半结肠癌根治术两种术式的临床效果.方法 对524例右半结肠癌患者进行手助腹腔镜右半结肠癌根治术(手助腹腔镜组,n=231)或全腹腔镜右半结肠癌根治术(全腹腔镜组,n=293).对两组手术操作时间、术中出血量、术后疼痛评分、术后引流量、术后胃肠功能恢复时间、并发症、住院时间、总费用、切口美容评分等指标进行比较.结果 手术操作时间、术中出血量及术后引流量手助腹腔镜组明显低于全腹腔镜组[(112.4±52.9)、(148.5±61.7) min,(105.6±49.5)、(171.5±72.4)ml,(54.9±17.6)、(28.6±15.7) ml],差异均有统计学意义(P值分别为0.032、0.041、0.039);术后胃肠功能恢复时间手助腹腔镜组明显高于全腹腔镜组[(69.4±21.8)、(53.4±21.7) h],差异有统计学意义(P=0.008);并发症发生率、住院时间及总费用两组间比较差异均无统计学意义(P均＞0.05);手助腹腔镜组轻度疼痛35例,中度121例,重度75例;全腹腔镜组轻度疼痛96例,中度146例,重度51例,差异有统计学意义(P=0.027);切口美容评分全腹腔镜组高于手助腹腔镜组[(4.3±0.9)、(2.4±0.6)分],差异有统计学意义(P=0.002).结论 手助腹腔镜右半结肠癌根治术中操作较为便捷且节省手术时间,全腹腔镜右半结肠癌根治术创伤小,患者满意度高,综合分析全腹腔镜操作优于手助操作.
目的 探討採用手助腹腔鏡與全腹腔鏡右半結腸癌根治術兩種術式的臨床效果.方法 對524例右半結腸癌患者進行手助腹腔鏡右半結腸癌根治術(手助腹腔鏡組,n=231)或全腹腔鏡右半結腸癌根治術(全腹腔鏡組,n=293).對兩組手術操作時間、術中齣血量、術後疼痛評分、術後引流量、術後胃腸功能恢複時間、併髮癥、住院時間、總費用、切口美容評分等指標進行比較.結果 手術操作時間、術中齣血量及術後引流量手助腹腔鏡組明顯低于全腹腔鏡組[(112.4±52.9)、(148.5±61.7) min,(105.6±49.5)、(171.5±72.4)ml,(54.9±17.6)、(28.6±15.7) ml],差異均有統計學意義(P值分彆為0.032、0.041、0.039);術後胃腸功能恢複時間手助腹腔鏡組明顯高于全腹腔鏡組[(69.4±21.8)、(53.4±21.7) h],差異有統計學意義(P=0.008);併髮癥髮生率、住院時間及總費用兩組間比較差異均無統計學意義(P均＞0.05);手助腹腔鏡組輕度疼痛35例,中度121例,重度75例;全腹腔鏡組輕度疼痛96例,中度146例,重度51例,差異有統計學意義(P=0.027);切口美容評分全腹腔鏡組高于手助腹腔鏡組[(4.3±0.9)、(2.4±0.6)分],差異有統計學意義(P=0.002).結論 手助腹腔鏡右半結腸癌根治術中操作較為便捷且節省手術時間,全腹腔鏡右半結腸癌根治術創傷小,患者滿意度高,綜閤分析全腹腔鏡操作優于手助操作.
목적 탐토채용수조복강경여전복강경우반결장암근치술량충술식적림상효과.방법 대524례우반결장암환자진행수조복강경우반결장암근치술(수조복강경조,n=231)혹전복강경우반결장암근치술(전복강경조,n=293).대량조수술조작시간、술중출혈량、술후동통평분、술후인류량、술후위장공능회복시간、병발증、주원시간、총비용、절구미용평분등지표진행비교.결과 수술조작시간、술중출혈량급술후인류량수조복강경조명현저우전복강경조[(112.4±52.9)、(148.5±61.7) min,(105.6±49.5)、(171.5±72.4)ml,(54.9±17.6)、(28.6±15.7) ml],차이균유통계학의의(P치분별위0.032、0.041、0.039);술후위장공능회복시간수조복강경조명현고우전복강경조[(69.4±21.8)、(53.4±21.7) h],차이유통계학의의(P=0.008);병발증발생솔、주원시간급총비용량조간비교차이균무통계학의의(P균＞0.05);수조복강경조경도동통35례,중도121례,중도75례;전복강경조경도동통96례,중도146례,중도51례,차이유통계학의의(P=0.027);절구미용평분전복강경조고우수조복강경조[(4.3±0.9)、(2.4±0.6)분],차이유통계학의의(P=0.002).결론 수조복강경우반결장암근치술중조작교위편첩차절성수술시간,전복강경우반결장암근치술창상소,환자만의도고,종합분석전복강경조작우우수조조작.
Objective To investigate the clinical application value of hand-assistant laparoscopy and total laparoscopy in radical right colectomy.Methods Five hundred and twenty-four patients were selected as our subjects who performed by hand-assistant laparoscopic radical right colectomy (213 cases) or total laparoscopic radical right colectomy (293 cases) in colon cancer therapy.The operation durations,bleeding volumes,postoperative pain scores,postoperative draining volumes,recovery time of gastrointestinal function,hospitalization times,hospitalization expenses,postoperative complications and cosmetic satisfactory scores were recorded and compared.Results The operation durations,bleeding volumes,postoperative draining volumes in hand-assistant laparoscopic group were (112.4±52.9) min,(105.6 ± 49.5) ml,(28.6± 15.7) ml,lower than those in total laparoscopic group((148.5±61.7) min,(171.5±72.4) ml,(28.6±15.7) ml;P=0.032,0.041,0.039).The recovery time of gastrointestinal function of hand-assistant laparoscopic group were (69.4±21.8) h,longer than total laparoscopic group ((53.4 ± 21.7) h;P =0.008).The hospitalization times,hospitalization expenses,postoperative complications of hand-assistant laparoscopic group were as same as total laparoscopic group(P＞0.05).Hand-assisted laparoscopic group mild pain in 35 cases,121 cases of moderate and severe 75 cases;Total 96 cases of mild pain in laparoscopic group,146 cases of moderate and severe in 51 cases,the difference was statistically significant(P=0.027).Beauty score incision of laparoscopic group was higher than in the whole hand-assisted laparoscopic group,the difference was statistically significant ((4.3 ± 0.9) score vs.(2.4±0.6) score;P=0.002).Conclusion Hand-assistant laparoscopic radical right colectomy is convenient and more quickly for operation.Total laparoscopic radical right colectomy has advantage in terms of less injury and the patients are more satisfactory.For practiced operators,total laparoscopic radical right colectomy is recommended cosmetic satisfactory score.
