Guan Guo-xian, Liu Xing, Jiang Wei-zhong, Chen Zhi-fen, Lu Hui-shan
Department of Surgical Oncology, Fujian Medical University, Fuzhou 350001,China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2010 Dec;13(12):917-20.
To explore the feasibility and short-term efficacy of laparoscopic-assisted D3 lymph node dissection for right colon cancer with a medial-to-lateral approach.
Clinical data of 61 patients with right colon cancer undergoing D3 lymph node dissection from March 2006 to June 2010 were analyzed retrospectively. Among them,29 underwent laparoscopic-assisted right hemicolectomy (LARH group) and 32 underwent open right hemicolectomy (ORH group). The number of lymph node harvest, operative details, and complication rate were compared between the two groups.
The mean number of lymph node harvest did not differ significantly between the two groups (16.9±3.8 vs. 15.4±3.6). As compared to ORH group, although the operative time was significantly longer [(214.4±37.9) min vs. (193.3±28.8) min] in LARH group, the mean blood loss [(83.4±38.0) ml vs. (192.7±43.6) ml], time to first flatus [(44.6±20.8) h vs. (70.4±80.0) h], time to resumption of soft diet[(32.5±10.6) h vs. (59.7±10.4) h], and postoperative hospital stay [(11.2±2.2) d vs. (13.8±2.8) d] were more favorable(all P<0.05). Complication rate was lower in LARH group(10.4% vs. 9.4%), however the difference was not statistically significant.
LARH with D3 lymph node dissection is oncologically comparable with ORH for right colon cancer. It is a safe and feasible procedure associated with rapid postoperative recovery.
探讨腹腔镜辅助下由内侧向外侧入路行右半结肠癌D3淋巴结清扫术的可行性及短期疗效。
回顾性分析2006年3月至2010年6月期间61例行D3淋巴结清扫术的右半结肠癌患者的临床资料。其中,29例行腹腔镜辅助右半结肠切除术(LARH组),32例行开腹右半结肠切除术(ORH组)。比较两组的淋巴结清扫数量、手术细节及并发症发生率。
两组平均淋巴结清扫数量差异无统计学意义(16.9±3.8 vs. 15.4±3.6)。与ORH组相比,LARH组手术时间虽显著延长[(214.4±37.9)分钟 vs. (193.3±28.8)分钟],但平均失血量[(83.4±38.0)毫升 vs. (192.7±43.6)毫升]、首次排气时间[(44.6±20.8)小时 vs. (70.4±80.0)小时]、恢复软食时间[(32.5±10.6)小时 vs. (59.7±10.4)小时]及术后住院时间[(11.2±2.2)天 vs. (13.8±2.8)天]均更优(均P<0.05)。LARH组并发症发生率较低(10.4% vs. 9.4%),但差异无统计学意义。
腹腔镜辅助下右半结肠癌D3淋巴结清扫术在肿瘤学方面与开腹手术相当。这是一种安全可行的手术,术后恢复快。