| 王志勇,姜 超,邹 坤,许 哲,吴冠楠.腹腔镜下头侧中间入路治疗直肠癌患者的近期疗效及对第253组淋巴结的清扫效果分析[J].,2021,(21):4163-4166 |
| 腹腔镜下头侧中间入路治疗直肠癌患者的近期疗效及对第253组淋巴结的清扫效果分析 |
| Short-term Effect of Laparoscopic Treatment of Rectal Cancer by Cephalic Middle Approach and Analysis of Group 253 Lymph Node Dissection |
| 投稿时间：2021-04-06 修订日期：2021-04-28 |
| DOI：10.13241/j.cnki.pmb.2021.21.034 |
| 中文关键词: 头侧中间入路 腹腔镜 直肠癌 253组淋巴结 近期疗效 |
| 英文关键词: Cephaladal approach Laparoscopic Rectal cancer group 253 lymph nodes Short-term efficacy |
| 基金项目:江苏省中医药科技发展计划项目（YB201916） |
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| 中文摘要: |
| 摘要 目的：分析头侧中间入路对腹腔镜直肠癌患者的近期疗效及第253组淋巴结的清扫效果。方法：2017年6月到2020年6月选择在江苏省中医院诊治的80例直肠癌作为研究对象，根据手术入路方式的不同分为中间组42例与外侧组38例。所有患者都给予腹腔镜直肠癌根治术治疗，中间组采用头侧中间入路，外侧组给予外侧入路，记录与随访近期疗效及第253组淋巴结的清扫效果。结果：所有患者手术过程顺利，吻合后系膜、肠管均无张力；中间组的第253组淋巴结清扫时间少于外侧组(P<0.05)，两组的第253组淋巴结清扫数量对比差异无统计学意义(P>0.05)。两组的手术时间、术中出血量对比差异无统计学意义(P>0.05)，中间组的术后肛门首次排气时间、术后拔除引流管时间、术后住院时间显著少于外侧组(P<0.05)。中间组术后9个月的肠梗阻、吻合口漏、吻合口出血、切口感染等并发症发生率为4.8 %，显著低于外侧组23.7 %(P<0.05)。所有患者术后随访9个月，中间组的复发率为2.4 %，显著低于外侧组的15.8 %(P<0.05)。结论：头侧中间入路在腹腔镜直肠癌患者中的应用能提高第253组淋巴结的清扫效率，促进患者康复，减少术后并发症的发生，降低近期复发率。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the short-term efficacy of the anterior middle approach for laparoscopic rectal cancer and the group 253 lymph node dissection. Methods: A total of 80 cases of rectal cancer, who were diagnosed and treated in Jiangsu Provincial Hospital of Traditional Chinese Medicine from June 2017 to June 2020, were selected and were divided into middle group(n=42) and lateral group(n=38) according to the different surgical approaches. All the patients were treated with laparoscopic rectal cancer resection, the middle group was received the anterior approach and the lateral group, received the lateral approach. The short-term efficacy and the group 253 lymph nodes dissection effects were recorded and followed up. Results: All the patients underwent smooth operation, and there was no tension in the mesentery and intestine after anastomosis. The group 253 lymph node dissection time in the middle group was less than that in the lateral group(P<0.05), and there was no statistical difference in the number of group 253 lymph node dissection between the two groups(P>0.05). There was no significant difference in the operation time and intraoperative blood loss between the two groups(P>0.05). The postoperative anal first exhaust time, postoperative drainage tube removal time, and postoperative hospital stay in the middle group were significantly less than those in the lateral group(P<0.05). The postoperative 9 months of incidences of complications such as intestinal obstruction, anastomotic leakage, anastomotic bleeding, and wound infection in the middle group was 4.8 %, which was significantly lower than that(23.7 %) in the lateral group (P<0.05). All the patients were followed up for 9 months, and the recurrence rate of the middle group was 2.4 %, which was significantly lower than that (15.8 %) of the lateral group (P<0.05). Conclusion: The application of the anterior middle approach in patients with laparoscopic rectal cancer can improve the cleaning efficiency of the group 253 lymph node, promote the recovery of patients, reduce the incidence of postoperative complications, and reduce the short-term recurrence rate. |
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