Curative effect of two-hole and four-hole laparoscopic surgery on sigmoid carcinoma

YAN Ming; BAI Ri-xing; YAN Wen-mao; ZHONG Zhi-qiang

doi:10.11659/jjssx.06E023145

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Curative effect of two-hole and four-hole laparoscopic surgery on sigmoid carcinoma

Gastroenterology and Hepatobiliology | 更新时间：2024-10-22

- Curative effect of two-hole and four-hole laparoscopic surgery on sigmoid carcinoma
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 33, Issue 10, Pages: 859-862(2024)
- 作者机构：
  
  首都医科大学附属北京天坛医院普通外科，北京 100070
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.06E023145
  CLC： R615
- Published：25 October 2024，
  
  Received：26 June 2023，
- 稿件说明：
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闫鸣,白日星,闫文貌等.两孔法与四孔法腹腔镜手术对乙状结肠癌的疗效分析[J].局解手术学杂志,2024,33(10):859-862.

YAN Ming,BAI Ri-xing,YAN Wen-mao,et al.Curative effect of two-hole and four-hole laparoscopic surgery on sigmoid carcinoma[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(10):859-862.
闫鸣,白日星,闫文貌等.两孔法与四孔法腹腔镜手术对乙状结肠癌的疗效分析[J].局解手术学杂志,2024,33(10):859-862. DOI： 10.11659/jjssx.06E023145.

YAN Ming,BAI Ri-xing,YAN Wen-mao,et al.Curative effect of two-hole and four-hole laparoscopic surgery on sigmoid carcinoma[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(10):859-862. DOI： 10.11659/jjssx.06E023145.

摘要

目的

分析两孔法、四孔法腹腔镜手术治疗乙状结肠癌患者的疗效，并探讨导致并发症发生的影响因素。

方法

对我院2020年10月至2022年12月行腹腔镜手术治疗的130例乙状结肠癌患者的临床资料进行分析，根据患者手术开孔方式进行分组，两孔组68例患者采用两孔法腹腔镜手术，四孔组62例患者采用四孔法腹腔镜手术。观察并比较2组患者的围术期指标、视觉模拟量表（VAS）评分及术后并发症情况，分析并发症发生的影响因素。

结果

两孔组患者手术切口总长度、术后首次下床时间、术后首次肛门排气时间、术后住院时间及术后各时点VAS评分均明显短/低于四孔组（

0.05）。2组并发症发生率比较，差异无统计学意义（

0.05）。单因素分析发现，发生组与未发生组患者年龄、术前白蛋白、手术时间、术中出血量、术后首次下床时间、术后首次肛门排气时间、术后住院时间及术后3 d、5 d的VAS评分比较，差异有统计学意义（

0.05）；进一步行

Logistic

回归分析显示：手术时间、术前白蛋白

35 g/L是并发症发生的主要影响因素（

0.05）。

结论

与四孔法腹腔镜手术比较，两孔法腹腔镜手术治疗乙状结肠癌患者围术期康复明显更快，术后疼痛更轻，术后并发症发生率并无差异。手术时间、术前白蛋白水平<35g/L是并发症发生的主要影响因素。

Abstract

Objective

To analyze the efficacy of two-hole and four-hole laparoscopic surgery in patients with sigmoid carcinoma， and to explore the influencing factors leading to complications.

Methods

The clinical data of 130 patients with sigmoid carcinoma who underwent laparoscopic surgery in our hospital from October 2020 to December 2022 were analyzed. The patients were divided into groups according to the surgical perforation methods. Sixty-eight patients in two-hole group were treated with two-hole laparoscopic surgery and 62 patients in four-hole group were treated with four-hole laparoscopic surgery. The perioperative indexes， visual analogue scale （VAS） scores and postoperative complications of patients in the two groups were observed and compared， and the influencing factors of complications were analyzed.

Results

The total incision length， first time to get out of bed， first postoperative exhaust time， postoperative hospital stay and VAS score at each time poi

nt after surgery of patients in two-hole group were significantly shorter/lower than those in four-hole group （

0.05）. There was no statistically significant difference in the incidence of complications between the two groups（

0.05）. Univariate analysis showed that there were statistically significant differences in the age，preoperative albumin， operation time， intraoperative blood loss， first time to get out of bed， first postoperative exhaust time， postoperative hospital stay， VAS scores at the 3rd day and 5th days after surgery of patients in the occurrence group and the non-occurrence group（

0.05）. Further

Logistic

regression analysis showed that operation time and preoperative albumin

35 g/L were the main influencing factors for the occurrence of complications （

0.05）.

Conclusion

Compared with four-hole laparoscopic surgery， two-hole laparoscopic surgery for patients with sigmoid carcinoma has shorter time of perioperative recovery，less postoperative pain， and no difference was found in postoperative complications between the two methods. Operation time and preoperative albumin level <35 g/L were the main influencing factors for the occurence of complications.

关键词

腹腔镜两孔法四孔法乙状结肠癌并发症

Keywords

laparoscopetwo-hole methodfour-hole methodsigmoid carcinomacomplication

references

姚宏伟，张忠涛.从全国结直肠癌手术病例数据库论述结直肠癌外科诊断与治疗的规范化［J］. 中华消化外科杂志， 2020，19（1）：55-58. doi：10.3760/cma.j.issn.1673-9752.2020.01.009http://dx.doi.org/10.3760/cma.j.issn.1673-9752.2020.01.009.

孙跃明.结直肠癌外科治疗进展［J］. 中华消化外科杂志， 2024，23（6）：789-794. doi：10.3760/cma.j.cn115610-20240508-00243http://dx.doi.org/10.3760/cma.j.cn115610-20240508-00243.

Soylu D，Kartin PT. The effect on gastrointestinal system functions，pain and anxiety of acupressure applied following laparoscopic cholecystectomy operation： a randomised，placebo-controlled study［J］. Complement Ther Clin Pract，2021，43：101304.doi：10.1016/j.ctcp.2021.101304http://dx.doi.org/10.1016/j.ctcp.2021.101304.

Yang H，Zhang Z，Zhao K，et al. Extraperitoneal laparoscopic radical cystectomy with preservation of fertility for the treatment of ewing sarcoma： the first report of a reliable surgical method［J］. Urology，2021，159：241-246.doi： 10.1016/j.urology.2021.09.024http://dx.doi.org/10.1016/j.urology.2021.09.024.

田利飞，仝聪，阎立昆，等. 三人四孔法在腹腔镜腹股沟疝感染补片取出术中的应用观察［J］. 山东医药，2022，62（33）：23-26.doi：10.3969/j.issn.1002-266X.2022.33.006http://dx.doi.org/10.3969/j.issn.1002-266X.2022.33.006.

Jacob KC，Patel MR，Alexander MS，et al.Theeffect of the severity of preoperative back pain on patient reported outcomes，recovery ratios，and patient satisfaction following MIS-TLIF［J］.World Neurosurg，2021，156：254-265.doi： 10.1016/j.wneu.2021.09.053http://dx.doi.org/10.1016/j.wneu.2021.09.053.

Fujimoto T，Kato Y，Okai T，et al. Acinar cell carcinoma of the pancreas with repeated shrinkage and expansion of the tumor until operation： a case report［J］. Pathol Int，2022，72（3）：193-199.

张睿，许磊，王凯.两孔法和三孔法腹腔镜直肠癌切除术治疗低位直肠癌患者的效果比较［J］.医学临床研究，2022，39（2）：298-300.doi：10.3969/j.issn.1671-7171.2022.02.040http://dx.doi.org/10.3969/j.issn.1671-7171.2022.02.040.

欧作强，蒋丹华，黄高杰，等.改良三孔法与常规四孔法腹腔镜手术治疗小儿先天性胆总管囊肿的对比研究［J］.腹腔镜外科杂志，2023，28（2）：138-143.doi：10.13499/j.cnki.fqjwkzz.2023.02.138http://dx.doi.org/10.13499/j.cnki.fqjwkzz.2023.02.138.

韩旭，王书举，谷华丽.经脐单一切口法与四孔法腹腔镜囊肿切除对小儿胆总管囊肿的疗效比较及对机体炎症和应激反应的影响［J］.肝胆胰外科杂志，2021，33（7）：401-406.doi：10.11952/j.issn. 1007-1954.2021.07.004http://dx.doi.org/10.11952/j.issn.1007-1954.2021.07.004.

廖良功，胡俊杰，张弛，等.两孔与四孔法腹腔镜手术治疗结直肠癌的近期临床疗效比较［J］.中华胃肠外科杂志，2022，25（8）：737-740.doi：10.3760/cma.j.cn441530-20220302-00077http://dx.doi.org/10.3760/cma.j.cn441530-20220302-00077.

周仕海，陈宏，雒洪志，等. 经直肠与经腹部小切口取出标本的腹腔镜乙状结肠癌根治术的比较［J］. 中国微创外科杂志，2022，22（4）：303-307.doi：10.3969/j.issn.1009-6604.2022.04.004http://dx.doi.org/10.3969/j.issn.1009-6604.2022.04.004.

文静，张志云，张艳华，等.肝硬化门静脉高压症合并原发性肝癌患者腹腔镜术后并发症危险因素分析［J］.护理学杂志，2023，38（6）：27-31.doi：10.3870/j.issn.1001-4152.2023.06.027http://dx.doi.org/10.3870/j.issn.1001-4152.2023.06.027.

胡康，谭可，童卫东，等. 术后白蛋白下降分数对直肠癌保肛术后并发症及长期预后的预测价值［J］. 第三军医大学学报，2021，43（19）：1899-1908.doi：10.16016/j.1000-5404.2021 04019http://dx.doi.org/10.16016/j.1000-5404.202104019.

赵国泉，王利洪，曾国利，等. 骨科患者围术期白蛋白，C反应蛋白变化与术后感染性并发症的关系分析［J］. 实用医院临床杂志，2021，18（5）：163-166.doi：10.3969/j.issn.1672-6170. 2021. 05.044http://dx.doi.org/10.3969/j.issn.1672-6170.2021.05.044.

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