| 谢就坤,徐一劲,汤献忠,等.全腹腔镜下改良三角吻合技术治疗乙状结肠癌的疗效及预后[J].安徽医药,2021,25(5):910-913. |
| 全腹腔镜下改良三角吻合技术治疗乙状结肠癌的疗效及预后 |
| The effect and prognosis of improved laparoscopic triangular anastomosis in the treatment of sigmoid colon cancer |
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| DOI：10.3969/j.issn.1009-6469.2021.05.015 |
| 中文关键词: 乙状结肠肿瘤 腹腔镜 改良三角吻合 消化道重建 疗效 并发症 |
| 英文关键词: Sigmoid neoplasms Laparoscopy Modified triangular anastomosis Digestive tract reconstruction Efficacy Complications |
| 基金项目:东莞市科技发展项目( 201650715001399) |
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| 摘要点击次数: 1647 |
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| 中文摘要: |
| 目的探讨全腹腔镜下改良三角吻合技术治疗乙状结肠癌的疗效及预后，为选择临床治疗方案提供参考。方法选取 2018年 9月至 2019年 7月东莞市人民医院接受腹腔镜乙状结肠癌根治术治疗的结肠癌病人 98例。根据简单随机分组法分成观察组 48例与对照组 50例。对照组采用腹腔镜辅助小切口重建治疗，观察组采用全腹腔镜下改良三角吻合技术治疗。随访 6个月，比较两组手术指标、手术效果、术后数字疼痛强度量表( NRS)评分、并发症及复发转移情况。结果观察组总手术时间、消化道重建时间、肛门排气时间［(147.37±31.64)min、(32.25±9.03)min、(2.93±0.85)d)］均短于对照组［( 163.92±34.85) min、(41.16±11.89)min、(3.70±1.02)d］差异有统计学意义( P<0.05)；观察组术中出血量、下地活动时间、住院时间与对照组比较，差异无统计学意义(P>0.05)。观察组，淋巴结清扫数、肠管切除长度、肿瘤大小、肿瘤分期与对照组比较，差异无统计学意义(P>0.05)。观察组病人术后第 1天、第 3天 NRS评分［( 3.75±0.72)分、(2.81±0.65)分］明显低于对照组［( 4.38±0.83)分、(3.46±0.74)分)］差异有统计学意义( P<0.05)；两组病人术后第 5天 NRS评分比较，差异无统计学意义(P>0.05)。观察组病人围术期并发率为 1042%，低于对照组病人的 12.00%，但差异无统计学意义( P>0.05)。随访 6个月，两组病人均未出现肿瘤局部复发或远处转移情况。结论全腹腔镜下改良三角吻合技术治疗乙状结肠癌的疗效显著，且可缩短手术时间，促进肠道康复，减轻.，术后疼痛，具有临床推广应用价值。 |
| 英文摘要: |
| Objective To explore the curative effect and prognosis of the improved triangular anastomosis technique under total laparoscopic surgery in the treatment of sigmoid colon cancer, so as to provide reference for the selection of clinical treatment options.Methods A total of 98 patients who underwent laparoscopic radical sigmoid carcinoma treatment from September 2018 to July 2019 were selected asthe research subjects. According to simple random grouping method, 48 cases were divided into observation group and 50 cases in controlgroup. The control group was treated with laparoscopic assisted small incision reconstruction, and the observation group was treated with modified laminoscopic anastomosis.Followed up for 6 months,the surgical indexes,surgical effects,postoperative VAS painscores,compli-cations,and recurrence and metastasis were compared between the two groups of patients.Results The total operation time,digestive tract reconstruction, and anal exhaust time [(147.37 ± 31.64)min, (32.25 ± 9.03)min, (2.93 ± 0.85)d] in the observation group were shorter thanthose in the control group (163.92 ± 34.85)min, (41.16 ± 11.89)min,(3.70 ± 1.02)d, the difference was statistically significant (P<0.05); theintraoperativeblood loss,groundactivity time,and lengthofhospitalstayoftheobservationgroupwerenotsignificantlydifferentfrom thoseof the control group (P >0.05). Compared with the control group, the number of lymph node dissections, intestinal resection length, tumorsize, and tumor stage in the observation group were not statistically significant (P>0.05). The VAS pain scores[ (3.75 ± 0.72)points, (2.81 ±0.65) points] of patients in the observation group on the first and third postoperative days were lower than those in the control group [(4.38 ±0.83)points(3.46±0.74)points],and the differences were statistically significant (P<0.05);there wasnosignificantdifferenceinVASpain scores between thetwo groupson the 5thdayaftersurgery (P>0.05). The perioperative rate in the observation group was 10.42%, whi chwas significantly lower than 12.00% in the control group, but the difference was not statistically significant(P>0.05).Conclusion The improved triangular anastomosis technique under full laparoscopy is effective in treating sigmoid colon cancer,and it can shorten the operation time,promote postoperative rehabilitation,reduce postope rative pain,and have clinical application value. |
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