经尾侧入路联合中间翻页式与传统腹腔镜下右半结肠癌根治术临床对比研究分析

Clinical Comparative Study of Caudal Approach Combined with Middle Page Turn-ing and Traditional Laparoscopic Radical Resection of Right Colon Cancer

摘要: 目的：比较经尾侧入路联合中间翻页式与传统腹腔镜下右半结肠癌根治术临床治疗效果，为临床提供理论依据。方法：选择2018年01月至2021年11月大理大学第一附属医院普外科行腹腔镜下右半结肠癌根治术的56例患者的临床资料，根据不同的手术入路，分为实验组(经尾侧入路联合中间翻页式入路)和对照组(传统入路)，其中，尾侧入路联合中间翻页式组27例，传统中间入路组29例，观察两组的基本资料(年龄、BMI、性别)、CEA值、术前血红蛋白及白蛋白量、术后血红蛋白及白蛋白量、手术时长、术中出血量、术中淋巴结清扫数、术后排便时间、术后排气时间、术后进食时间、术后住院天数、术后并发症、住院费用等情况。比较两组手术入路的临床效果。结果：尾侧入路联合中间翻页式组的手术时长、术中出血量、术后排便时间、住院费用均少于传统中间入路组，差异具有统计学意义(P < 0.05)。两组术中淋巴结清扫数、术后排气时间、术后进食时间、术后住院天数、术后并发症差异无统计学意义(P > 0.05)。结论：与传统入路相比，尾侧入路联合中间翻页式具有手术时长短、术中出血量少、术后排便时间短、住院费用少等优势，值得临床应用与推广。

Abstract: Objective: To compare the clinical therapeutic effects of caudal approach combined with middle page turning and traditional laparoscopic radical resection of right colon cancer, so as to provide theoretical basis for clinic. Methods: The clinical data of 56 patients who underwent laparoscopic radical resection of right colon cancer in the department of general surgery of the First Affiliated Hospital of Dali University from January 2018 to November 2021 were selected. According to dif-ferent surgical approaches, they were divided into experimental group (caudal approach combined with middle flipping approach) and control group (traditional approach). Among them, there were 27 cases in caudal approach combined with middle flipping approach and 29 cases in traditional middle approach. The basic data (age, BMI, gender), CEA value, preoperative hemoglobin and al-bumin, postoperative hemoglobin and albumin, operation time, intraoperative bleeding, in-traoperative lymph node dissection, postoperative defecation time, postoperative exhaust time, postoperative eating time, postoperative hospital stay, postoperative complications and hospitali-zation expenses of the two groups were observed. The clinical effects of the two groups were com-pared. Results: The operation time, intraoperative bleeding, postoperative defecation time and hospitalization expenses of the caudal approach combined with the middle page turning group were significantly lower than those of the traditional middle approach group (P < 0.05). There was no significant difference in the number of lymph node dissection, postoperative exhaust time, postoperative eating time, postoperative hospital stay and postoperative complications between the two groups (P > 0.05). Conclusion: Compared with the traditional approach, the caudal approach combined with the middle page turning approach has the advantages of long operation time, less intraoperative bleeding, short postoperative defecation time and less hospitalization cost. It is worthy of clinical application and promotion.