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目的:比较腹腔镜辅助与开腹手术行右半结肠切除术治疗结肠恶性肿瘤的临床疗效。方法:病例来源于2013年2月至2015年11月我院收治的结肠恶性肿瘤病患者90例。按随机数字表法分为观察组和对照组,数字为偶数者为观察组,奇数者为对照组,每组45例。两组患者术前均行常规检查并纠正患者存在的贫血、电解质紊乱等合并症后,对照组所有纳入病例行开腹手术进行治疗,观察组所有纳入病例采用腹腔镜辅助下的右半肠切除术进行治疗,记录并比较两组患者的手术情况及术后恢复情况,并对两组术后并发症的发生情况进行比较,此外随访记录两组患者的累计生存率。结果:观察组术中出血量、切口长度及淋巴清扫个数均明显低(或少)于对照组,差异具有统计学意义(P<0.05);观察组患者术后排气时间、胃肠道恢复时间、住院时间均明显短于对照组,差异具有统计学意义(P<0.05),此外观察组患者术后3d平均引流量明显多于对照组,差异具有统计学意义(P<0.05);观察组患者并发症的发生率明显低于对照组,存在显著性差异(P<0.05);术后对两组患者均进行为期5年随访,观察组1年、3年、5年的存活率与对照组比较均不存在显著性差异(P>0.05)。结论:采用腹腔镜辅助右半结肠切除术治疗结肠恶性肿瘤患者具有创伤小、手术时间短、术后恢复快、安全性高的优势,短期效果亦明显优于开腹手术,值得在临床推广使用。
OBJECTIVE: To compare the clinical efficacy of laparoscopic-assisted and open surgery in treating right colon cancer with colon cancer. Methods: The cases were from 90 patients with colon malignant tumor admitted to our hospital from February 2013 to November 2015. According to the method of random number table divided into observation group and control group, the number is even number for the observation group, odd number for the control group, 45 cases in each group. All patients in the two groups underwent routine examination before operation and all the patients had complications such as anemia and electrolyte imbalance. All the patients in the control group underwent laparotomy. All the patients in the observation group were treated with laparoscopic right half-gastrectomy The patients underwent surgery. The operation conditions and postoperative recovery of the two groups were recorded and compared. The incidence of postoperative complications was compared between the two groups. In addition, the cumulative survival rate of the two groups was recorded after follow-up. Results: The intraoperative blood loss, incision length and number of lymphadenectasia in the observation group were significantly lower (or less) than those in the control group (P <0.05). The postoperative exhaust time, gastrointestinal tract The recovery time and hospitalization time were significantly shorter than those in the control group (P <0.05). In addition, the average drainage volume in the observation group was significantly more than that in the control group after 3 days of operation. The difference was statistically significant (P <0.05). The incidence of complications in the observation group was significantly lower than that in the control group (P <0.05). After the operation, the patients in both groups were followed up for 5 years. The survival rates at 1 year, 3 years and 5 years in the observation group Compared with the control group, there was no significant difference (P> 0.05). Conclusion: The laparoscopic-assisted right hemilaminectomy for patients with malignant colon tumors has the advantages of less trauma, shorter operative time, faster recovery and higher safety. The short-term effect is also superior to laparotomy, which is worthy of clinical application .