王海家 葛晓伟 孟宏春

[摘要] 目的 比较开腹右半结肠癌根治术和腹腔镜辅助右半结肠癌根治术的手术安全性及临床疗效。 方法 选取2013年5月～2015年5月我院收治的83例右半结肠癌患者，按随机数字表法分为两组，腹腔镜组40例采用腹腔镜辅助右半结肠癌根治术，传统组43例行开腹右半结肠癌根治术。比较两组的手术情况、术后恢复程度、手术安全性、住院费用及随访情况。 结果 腹腔镜组术后排气时间、手术中出血量、切口直径、住院时间、首次下床时间及切口感染明显低于传统组（P<0.05）；腹腔镜组与传统组的手术时间、切除淋巴结数量、肠梗阻、吻合口瘘、吻合口狭窄、住院费用、转移率及存活率比较，差异无统计学意义（P>0.05）。 结论 与开腹右半结肠癌根治术比较，腹腔镜辅助右半结肠癌根治术术后并发症少，预后效果良好，是一种安全有效并能达到肿瘤根治效果的手术方式。

[关键词] 右半结肠癌根治术；腹腔镜；手术并发症；肿瘤根治效果

[中图分类号] R735.3 [文献标识码] B [文章编号] 1673-9701（2018）25-0051-04

[Abstract] Objective To compare the safety and clinical efficacy of open right colon cancer radical resection and laparoscopic right colon cancer radical resection. Methods A total of 83 patients with right colon cancer admitted from May 2013 to May 2015 in our hospital were selected and divided into two groups according to the random number table method. 40 patients in the laparoscopic group were treated with laparoscopic assisted right colon cancer radical surgery. 43 patients in the traditional group were given open right colon cancer radical resection. The operation situation， postoperative recovery degree， surgical safety， hospitalization costs and follow-up were compared between the two groups. Results Postoperative drainage time， intra operative blood loss， incision diameter， length of hospital stay， the first time to get out of bed and incision infection was significantly lower in the laparoscopic group than those in the traditional group（P<0.05）. There was no significant difference in the operative time， the number of lymph nodes removed， intestinal obstruction， anastomotic leakage， anastomotic stenosis， hospitalization costs， metastasis rate， and survival rate laparoscopic group and conventional group（P>0.05）. Conclusion Compared with open right colon cancer radical surgery， laparoscopic assisted radical right colon cancer surgery has fewer postoperative complications and better prognosis. It is a safe and effective surgical method that can achieve the effect of tumor radical resection.

[Key words] Right colon cancer radical surgery； Laparoscopy； Surgical complications； Tumor radical effect

開腹右半结肠癌根治术是目前临床上治疗右半结肠癌的常规术式[1]，此种术式操作简单，可以有效切除肿瘤及清除淋巴结，得到临床认可的肿瘤根治效果，但具有腹部切口过大、术中出血量过多的缺点，影响患者的术后恢复。近年来，随着腹腔镜在肿瘤外科的广泛应用，腹腔镜辅助右半结肠癌根治术具有对患者创伤小、恢复快等优势，但由于此手术难度系数较大，成为目前此手术在临床应用及发展的主要阻力[2]。本研究旨在探究两种术式的临床效果及价值体现，现报道如下。

1 资料与方法

1.1 一般资料

收集于2013年5月～2015年5月在我院行右半结肠癌根治术的患者83例。……