目的探讨腹腔镜下保留自主神经右半结肠癌D3根治术的可行性及应用价值。方法回顾性分析60例右半结肠癌患者的临床资料。所有患者均接受腹腔镜下右半结肠癌 D3根治术。根据是否切除肠系膜上神经丛,分为切除组(n=32)和保留组(n=28)。比较两组患者的手术指标和并发症发生情况。结果保留组手术时间短于切除组(P<0.05),乳糜漏和腹泻发生率低于切除组(P<0.05)。两组术中出血量、淋巴结清扫数量、术后肛门排气时间和住院时间差异无统计学意义(P>0.05)。结论腹腔镜下保留自主神经右半结肠癌D3根治术可行,且可避免因神经损伤而引发的术后胃肠功能紊乱及乳糜漏。
ObjectiveTo investigate the feasibility and application value of laparoscopic D3 radical resection preserving autonomic nerve for right colon cancer. MethodsThe clinical data of 60 patients with right colon cancer were analyzed retrospectively. All patients received laparoscopic D3 radical resection for right colon cancer. According to whether or not the superior mesenteric plexus was resected, patients were divided into resection group (n=32) or preservation group (n=28). Surgical indicators and the incidence of complications were compared between the two groups. ResultsThe operation duration of the preservation group was shorter than that of the resection group (P<0.05). The incidence of chylous leakage and diarrhea was lower in the preservation group than in the resection group (P<0.05). There was no statistically significant difference in intraoperative blood loss, the number of lymphadenectomy, postoperative anal exhaust time, or hospital stays between the two groups (P>0.05). ConclusionLaparoscopic D3 radical resection preserving autonomic nerve for right colon cancer is feasible, for it can avoid postoperative gastrointestinal disorder and chylous leakage caused by nerve injury.