■在微创外科领域,两孔腹腔镜手术正在上升。这项研究调查了与传统腹腔镜手术(CLS)相比,两孔腹腔镜手术(TLS)切除乙状结肠和上直肠癌的安全性和有效性。
■回顾性收集2019年7月至2022年1月在赣南医学院第一附属医院普外科行腹腔镜乙状结肠癌和上段直肠癌切除术患者的临床资料。根据腹腔镜手术的不同进行分组。根据纳入和排除标准,共纳入81例患者,在TLS组的25名患者中,和来自CLS组的56名患者。主要比较两组在手术时间上是否有统计学差异,术中出血,切口长度,到了第一次行走的时间,时间到了第一次排气,第一次排便的时间,术后并发症发生率,和其他手术结果。
■两组在基线临床特征方面无统计学差异(P>0.05)。就手术结果而言,总切口长度有统计学差异(TLS:6.21±0.67cm,CLS:8.64±1.08cm,P<0.001)),首次步行时间(TLS:2.0±0.7d,CLS:3.1±0.9d,P<0.001),至首次肛门排气的时间(TLS:2.5±0.8d,CLS:3.0±0.8d,P=0.028),首次排便时间(TLS:3.8±1.3d,CLS:5.1±2.1d,P=0.010),和流质饮食的时间(TLS:4.3±1.4d,CLS:5.3±1.9d,P=0.021)。两组在病理方面无统计学差别(P>0.05)。
■在安全方面,TLS在乙状结肠和上段直肠癌切除术中的应用与CLS相当。然而,它的切口更小,更美观,它造成的创伤比CLS小。此外,在术后恢复方面也优于CLS。
UNASSIGNED: In the field of minimally invasive surgery, the two-port laparoscopic surgery is on the rise. This study investigated the safety and efficacy of two-port laparoscopic surgery (TLS) for resecting sigmoid colon and upper rectal cancers compared with conventional laparoscopic surgery (CLS).
UNASSIGNED: The clinical data of patients undergoing laparoscopic sigmoid colon cancer and upper rectal cancer resection at the Department of General Surgery of the First Affiliated Hospital of Gannan Medical College between July 2019 and January 2022 were retrospectively collected. Grouped according to different laparoscopic surgery. Based on the inclusion and exclusion criteria,A total of 81 patients were enrolled, of the 25 patients from the TLS group,and of the 56 patients from the CLS group. We mainly compared whether there were statistical differences between the two groups in terms of operative time, intraoperative bleeding, incision length, time to first ambulation, time to first flatus, time to first defecation, postoperative complication rate, and other surgical outcomes.
UNASSIGNED: There was no statistical difference between the two groups in terms of baseline clinical characteristics (P > 0.05). In terms of the surgical outcomes, there were statistical differences in the total incision length (TLS: 6.21 ± 0.67 cm, CLS: 8.64 ± 1.08 cm, P < 0.001)), time to first ambulation (TLS: 2.0 ± 0.7 d, CLS:3.1 ± 0.9 d, P < 0.001), time to first flatus (TLS: 2.5 ± 0.8 d, CLS: 3.0 ± 0.8 d, P = 0.028), time to first defecation (TLS: 3.8 ± 1.3 d, CLS: 5.1 ± 2.1 d, P = 0.010), and time for liquid diet (TLS: 4.3 ± 1.4 d, CLS: 5.3 ± 1.9 d, P = 0.021). There was no statistical difference between the two groups in terms of the pathology (P > 0.05).
UNASSIGNED: In terms of safety, TLS in sigmoid colon and upper rectal cancer resection is comparable to CLS. However, its incision is smaller and more aesthetic, and it causes lesser trauma than CLS. Additionally, it is also superior to CLS in postoperative recovery.