论文部分内容阅读
目的:对比分析腹腔内吻合与腹腔外吻合对腹腔镜右半结肠切除术后相关腹腔感染的影响。方法:回顾性分析2015年1月至2019年12月于辽宁省大连市第三人民医院行腹腔镜右半结肠切除术的210例结肠癌患者的临床资料，其中79例术中行腹腔内吻合(内吻合组)，131例术中行腹腔外吻合(外吻合组)。分析两组患者围手术期指标以及术后腹腔感染情况。结果:内吻合组的术中出血量(45.2±4.2) mL 、手术时间(161.3±22.4) min 、淋巴结清扫数(30.8±9.6)枚、术后排气时间(3.3±1.2)d、术后住院时间(7.6±0.5)d,外吻合组分别为(42.1±5.0) mL、(167.3±26.7) min、(32.9±8.6)枚、(3.4±1.0)d、(7.5±0.6)d，两组比较差异均无统计学意义(n t值分别为0.417、0.207、0.829、0.338、0.293，n P值分别为0.699、0.845、0.231、0.734、0.802)；而内吻合组术后腹腔感染(伴吻合口瘘)占13.9%(11/79)、腹腔感染(不伴吻合口瘘)占10.1%(8/79)，外吻合组分别占1.5%(2/131)、0.8%(1/131)，两组比较差异有统计学意义(χn 2值分别为12.805、10.238，n P值分别为0.003、0.008)；内吻合组呼吸系统感染占1.3%(1/79)、泌尿系统感染占2.5%(2/79)、手术切口感染占1.3%(1/79)，外吻合组分别占3.1%(4/131)、0.8%(1/131)、3.1%(4/131)，两组比较差异均无统计学意义(χn 2值分别为0.662、0.420、0.662，n P值分别为0.364、0.587、0.364)。n 结论:实施腹腔镜右半结肠切除术时，术中采用腹腔内吻合虽然与腹腔外吻合有着相同的手术效果，但腹腔内吻合有增加患者术后腹腔感染的可能性。“,”Objective:To compare the effect of intracorporeal anastamosis and extracorporeal anastamosis on abdominal infection associated with laparoscopic right hemicolectomy.Methods:The clinical data of 210 patients with colon cancer who underwent laparoscopic right hemicolectomy in Dalian Third Peoples′s Hospital, Liaoning Province from January 2015 to December 2019 were analyzed retrospectively.Among them, 79 patients underwent intracorporeal anastamosis (intracorporeal anastamosis group) and 131 patients underwent extracorporeal anastamosis (extracorporeal anastamosis group). The perioperative indexes and postoperative abdominal infection were compared between the two groups.Results:In intracorporeal anastamosis group, the intraoperative bleeding was (45.2±4.2) mL, the operative time was (161.3±22.4) min, the number of lymph node dissection was (30.8±9.6), the postoperative exhaust time was (3.3±1.2) d, and the postoperative hospital stay was (7.6±0.5) d. In extracorporeal anastamosis group was (42.1±5.0) mL, (167.3±26.7) min, (32.9±8.6), (3.4±1.0) d and (7.5±0.6) d, respectively, there were no significant difference between the two groups (t value were 0.417, 0.207, 0.829, 0.338 and 0.293, respectively; P value were 0.699, 0.845, 0.231, 0.734 and 0.802, respectively). In intracorporeal anastamosis group, the incidence of abdominal infection (with anastomotic fistula)was 13.9%(11/79), the incidence of abdominal infection (without anastomotic fistula)was 10.1%(8/79), and in extracorporeal anastamosis group was 1.5%(2/131)and 0.8%(1/131), the differences were statistically significant (χn 2=12.805, 10.238; n P=0.003, 0.008). In intracorporeal anastamosis group, the incidence of respiratory system infection was 1.3%(1/79), the incidence of urinary system infection was 2.5%(2/79), the incidence of surgical incision infection was 1.3%(1/79). In extracorporeal anastamosis group was 3.1%(4/131), 0.8%(1/131) and 3.1%(4/131), respectively.There were no significant difference between the two groups (χn 2 value were 0.662, 0.420 and 0.662, respectively; P value were 0.364, 0.587 and 0.364, respectively).n Conclusion:Laparoscopic right hemicolectomy with intracorporeal anastamosis and extracorporeal anastamosis have the same surgical effect, but intracorporeal anastamosis may increase the risk of postoperative abdominal infection.