Department of Colon and Rectal Surgery, Chonnam National University Hwasun Hospital, Gwangju, Korea.
Tech Coloproctol. 2013 Feb;17(1):59-65. doi: 10.1007/s10151-012-0883-9. Epub 2012 Aug 31.
This study compared the short-term surgical outcomes of the vertical transumbilical incision with the left lower transverse incision for specimen retrieval in laparoscopic colorectal cancer surgery.
One hundred forty-seven consecutive patients scheduled for laparoscopic surgery for sigmoid colon and rectal cancer between April 2010 and December 2010 were classified into one of the two groups according to the site of the minilaparotomy: a transumbilical incision group (n = 92) and a left lower transverse incision group (n = 55).
Demographic data, operation time, estimated blood loss, frequency of transfusion, size of the tumor, number of harvested lymph nodes, distal resection margins, time to first flatus, and length of hospital stay were similar between the two groups. Postoperative pain scores were also similar between the two groups. The length of the minilaparotomy incision was shorter in the transumbilical group than the left lower transverse group at operation (mean, 4.6 vs. 6.2 cm, p = 0.000). The postoperative mean satisfaction score was higher in the transumbilical group, but this was not statistically significant (7.6 vs. 7.1, p = 0.224). Fourteen patients in the transumbilical group and 7 patients in the left lower transverse group developed wound-related complications (p = 0.810), including two cases of incisional hernia, both in the transumbilical group. High body mass index (≥25 kg/m(2)) and longer operative time (≥180 min) were risk factors for wound complications on univariate analysis.
Transumbilical minilaparotomy in laparoscopic colorectal surgery is a good alternative approach with acceptable wound complications.
本研究比较了经脐垂直切口与左下腹横切口在腹腔镜结直肠癌手术标本取出中的短期手术效果。
2010 年 4 月至 2010 年 12 月，147 例连续接受腹腔镜乙状结肠和直肠癌手术的患者根据小切口部位分为两组：经脐切口组（n=92）和左下腹横切口组（n=55）。
两组患者的人口统计学数据、手术时间、估计出血量、输血频率、肿瘤大小、淋巴结检出数、远端切缘、首次排气时间和住院时间均相似。两组患者术后疼痛评分也相似。手术中经脐组的小切口长度比左下腹横切口组短（平均 4.6cm 比 6.2cm，p=0.000）。经脐组的术后平均满意度评分较高，但无统计学意义（7.6 分比 7.1 分，p=0.224）。经脐组 14 例和左下腹横切口组 7 例患者发生与伤口相关的并发症（p=0.810），包括经脐组 2 例切口疝。单因素分析显示，高体质指数（≥25kg/m2）和较长的手术时间（≥180min）是伤口并发症的危险因素。
经脐小切口在腹腔镜结直肠手术中是一种可接受的方法，其伤口并发症发生率较低。
