[1]于秀芝,朱清海,刘海龙,等.单纯腹腔镜与腹腔镜联合肛门内镜手术在左半结肠癌根治术中的应用效果比较[J].新乡医学院学报,2017,34(3):224-227.[doi:10.7683/xxyxyxb.2017.03.018]
　YU Xiu-zhi,ZHU Qing-hai,LIU Hai-long,et al.Comparison of the effect of laparoscopic operation and laparoscopy combined with transanal endoscopic operation in the radical resection of left colon cancer[J].Journal of Xinxiang Medical University,2017,34(3):224-227.[doi:10.7683/xxyxyxb.2017.03.018]
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单纯腹腔镜与腹腔镜联合肛门内镜手术在左半结肠癌根治术中的应用效果比较
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
34
期数:
2017年3
页码:
224-227
栏目:
临床研究
出版日期:
2017-03-05

文章信息/Info

Title:
Comparison of the effect of laparoscopic operation and laparoscopy combined with transanal endoscopic operation in the radical resection of left colon cancer
作者:
于秀芝; 朱清海; 刘海龙; 郑　豪; 谭首海; 周　森
（驻马店市中心医院肛肠科，河南　驻马店　463000）
Author(s):
YU Xiu-zhi; ZHU Qing-hai; LIU Hai-long; ZHENG Hao; TAN Shou-hai; ZHOU Sen
（Department of Anorectal Surgery，the Central Hospital of Zhumadian City，Zhumadian 463000，Henan Province，China）
关键词:
腹腔镜手术; 肛门内镜手术; 左半结肠癌根治术
Keywords:
laparoscopic operation; transanal endoscopic operation; radical resection of left colon cancer
分类号:
R735.35
DOI:
10.7683/xxyxyxb.2017.03.018
文献标志码:
A
摘要:
目的　比较单纯腹腔镜与腹腔镜联合肛门内镜手术在左半结肠癌根治术中的应用效果。方法　选择2012年6月至2015年6月驻马店市中心医院收治的左半结肠癌患者136例，依据治疗方法分为对照组和观察组，每组68例，对照组患者采取单纯腹腔镜下左半结肠癌根治术，观察组患者采取腹腔镜联合肛门内镜手术，观察并记录2组患者的标本长度、淋巴结清除数量、淋巴结转移数量、手术时间、术中出血量、住院时间、腹壁切口总长度、术后镇痛药物应用次数、胃肠道功能恢复时间、术后并发症及术后1 a内复发、远处转移、死亡病例。结果　2组患者标本长度、淋巴结清除数量、淋巴结转移数量、手术时间、术中出血量、住院时间及术后胃肠道功能恢复时间比较差异均无统计学意义（P>0.05）。观察组患者腹壁切口总长度和术后镇痛药物应用次数显著低于对照组（P<0.05）。对照组患者术后发生腹腔感染2例，粘连性肠梗阻2例，切口感染1例，并发症发生率为7.4%（5/68）；观察组患者术后发生腹腔感染2例，粘连性肠梗阻3例，吻合口出血1例，并发症发生率为8.8%（6/68）；2组患者术后并发症发生率比较差异无统计学意义（P>0.05）。术后1 a，2组患者均无肿瘤复发、远处转移及死亡病例发生。结论　单纯腹腔镜与腹腔镜联合肛门内镜手术治疗左半结肠癌均可获得肯定疗效，且安全性好；与单纯腹腔镜手术相比，腹腔镜联合肛门内镜手术能够显著降低手术创伤，减少术后镇痛药物应用次数，尤其适用于肿瘤直径<4 cm的患者。
Abstract:
Objective　To compare the effect of laparoscopic operation and laparoscopy combined with transanal endoscopic operation in the radical resection of left colon cancer.Methods　A total of 136 patients with left colon cancer were selected from June 2012 to June 2015 in the Central Hospital of Zhumadian City.The patients were divided into observation group and control group，68 patients in each group.The patients in the control group were treated with laparoscopic radical resection of left colon cancer，and the patients in the observation group were treated with laparoscopy combined with transanal endoscopic operation.The length of specimen，number of cleared lymph node，number of lymph node metastasis，operation time，intraoperative bleeding，hospitalization time，total length of abdominal incision，postoperative analgesic drug application times，gastrointestinal function recovery time，postoperative complications and the cases of recurrence，distant metastasis，death within one year after operation were observed and recorded in the two groups.Results　There was no significant difference in the length of specimen，number of cleared lymph node，number of lymph node metastasis，operation time，intraoperative bleeding，hospitalization time and postoperative gastrointestinal function recovery time between the two groups （P>0.05）.The total length of abdominal incision and postoperative analgesic drug application times in the observation group were significantly lower than those in the control group（P<0.05）.There were two cases of celiac infection，two cases of adhesive intestinal obstruction and one case of incisional infection in the control group after operation；the incidence of complications was 7.4%(5/68).There were two cases of celiac infection，three cases of adhesive intestinal obstruction and one case of anastomotic bleeding in the observation group after operation；the incidence of complications was 8.8%(6/68).There was no significant difference in the incidence of postoperative complications between the two groups （P>0.05）.There was no cases of recurrence，distant metastasis and death in the two groups with one year after operation.Conclusion　The clinical efficacy and safety of both laparoscopic operation and laparoscopy combined with transanal endoscopic operation in the treatment of left colon cancer should be affirmed.Compared with the simple laparoscopic surgery，laparoscopy combined with transanal endoscopic operation can significantly reduce the surgical trauma，reduce the application of postoperative analgesic drug；it is especially suitable for patients with tumor diameter less than 4 cm.

参考文献/References:

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更新日期/Last Update: 2017-03-05