两孔法与四孔法腹腔镜手术对乙状结肠癌的疗效分析

闫鸣; 白日星; 闫文貌; 钟志强

doi:10.11659/jjssx.06E023145

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两孔法与四孔法腹腔镜手术对乙状结肠癌的疗效分析

胃肠肝胆专栏 | 更新时间：2024-10-22

- 两孔法与四孔法腹腔镜手术对乙状结肠癌的疗效分析
- Curative effect of two-hole and four-hole laparoscopic surgery on sigmoid carcinoma
- 局解手术学杂志 2024年33卷第10期页码：859-862
- 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：
  
  首都卫生发展科研专项(首发2020-1-2021)
- DOI：10.11659/jjssx.06E023145
  中图分类号： R615
- 纸质出版日期：2024-10-25，
  
  收稿日期：2023-06-26，
- 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

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