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三孔腹腔镜与五孔腹腔镜右半结肠切除术的短期疗效比较:倾向评分匹配分析。

Short-Term Outcomes of Three-Port Laparoscopic Right Hemicolectomy Versus Five-Port Laparoscopic Right Hemicolectomy: With a Propensity Score Matching Analysis.

机构信息

Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of General Surgery, Ruijin North Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

J Invest Surg. 2020 Oct;33(9):822-827. doi: 10.1080/08941939.2019.1579276. Epub 2019 Apr 4.

Abstract

: The aim of this study is to compare the short-term and pathological outcomes of TPLRC (Three-port laparoscopic right hemicolectomy) and FPLRC (Five-port laparoscopic right hemicolectomy), using propensity score matching analysis. One hundred and sixty-eight patients who accepted laparoscopic right hemicolectomy with either three ports or five ports from January 2013 to October 2017 were non-randomly selected and analyzed retrospectively. Propensity score matching model was used to eliminate the patients' selection bias between two groups. A total of 168 patients were involved. After propensity score matching, 39 for each group were compared. The number of harvested lymph nodes was significantly larger in the TPLRC group than in the FPLRC group (18.36 ± 8.58 vs. 14.90 ± 6.63,  = 0.048). A lower mean operative time was observed in the TPLRC group (136.24 ± 26.78 vs. 168.64 ± 43.68 min,  < 0.001). A less blood loss in the TPLRC group (62.44 ± 55.17, 135.54 ± 139.11 ml,  = 0.003). No significant differences in the other short-term outcomes between the two groups. TPLRC is a safe and feasible surgical procedure with similar results of FPLRC in short-term clinical outcomes. TPLRC has the advantages of shorter operative time, less blood loss and larger number of harvested lymph nodes. A randomized prospective clinical trial of long-term outcomes of TPLRC is required to further prove the present results.

摘要

本研究旨在通过倾向评分匹配分析比较三孔腹腔镜右半结肠切除术(TPLRC)与五孔腹腔镜右半结肠切除术(FPLRC)的短期和病理结局。回顾性非随机选择并分析了 2013 年 1 月至 2017 年 10 月期间接受腹腔镜右半结肠切除术的 168 例患者,这些患者分别采用三孔或五孔。使用倾向评分匹配模型消除两组间的患者选择偏倚。共纳入 168 例患者,经倾向评分匹配后,每组各 39 例。TPLRC 组的淋巴结清扫数目明显多于 FPLRC 组(18.36±8.58 比 14.90±6.63,=0.048)。TPLRC 组的平均手术时间明显缩短(136.24±26.78 比 168.64±43.68 分钟,<0.001)。TPLRC 组出血量较少(62.44±55.17,135.54±139.11 毫升,=0.003)。两组间其他短期结局无显著差异。TPLRC 是一种安全可行的手术,在短期临床结局方面与 FPLRC 结果相似。TPLRC 具有手术时间短、出血量少、淋巴结清扫数目多的优点。需要进行 TPLRC 长期结局的随机前瞻性临床试验来进一步证实目前的结果。

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