[1]钟克力** 夏利刚 胡海军 陈杰 李明伟 林烈文 郭春华.腹腔镜左半结肠切除术中结肠结肠侧侧吻合（Overlap）的临床价值[J].中国微创外科杂志,2019,01(11):996-999.
　Zhong Keli,Xia Ligang,Hu Haijun,et al.Clinical Value of Overlap Anastomosis in Laparoscopic Left Colectomy[J].Chinese Journal of Minimally Invasive Surgery,2019,01(11):996-999.
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腹腔镜左半结肠切除术中结肠结肠侧侧吻合（Overlap）的临床价值()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年11期
页码:
996-999
栏目:
临床研究
出版日期:
2019-11-25

文章信息/Info

Title:
Clinical Value of Overlap Anastomosis in Laparoscopic Left Colectomy
作者:
钟克力** 夏利刚 胡海军 陈杰 李明伟 林烈文 郭春华
（暨南大学第二临床学院广东省深圳市人民医院胃肠外科，深圳518020）
Author(s):
Zhong Keli;  Xia Ligang;  Hu Haijun;  et al.
Department of Gastrointestinal Surgery, Shenzhen People’s Hospital, Second Clinical College of Jinan University, Shenzhen 518020, China
关键词:
腹腔镜; 左半结肠切除术; Overlap吻合
Keywords:
Laparoscopy; Left hemicolectomy; Overlap anastomosis
文献标志码:
A
摘要:
目的探讨腹腔镜左半结肠切除术中结肠结肠侧侧吻合（Overlap）的临床应用价值。方法2014年5月~2017年10月，按患者及家属意愿将53例腹腔镜下左半结肠根治术分为腔内吻合组（19例）和腔外吻合组（34例）。腔内吻合组采用直线切割缝合器镜下完成Overlap吻合，扩大脐部观察孔至4 cm将标本和标本袋取出；腔外吻合组扩大左侧腹切口至4~6 cm，体外完成切除和结肠结肠端侧吻合。比较2组手术时间、术中出血量、术后24 h疼痛评分、肛门排气时间、术后住院时间、并发症和手术费用。结果腔内吻合组术后疼痛评分低［（5.6±1.4）分vs.（6.7±1.5）分，t=-2.508，P=0015］，但手术费用高［（2.8±0.4）万元vs. （2.1±0.4）万元，t=5.952，P=0.000］，2组手术时间、术中出血量、排气时间、术后住院时间、并发症无显著性差异（P>0.05）。结论腹腔镜左半结肠切除术采用Overlap吻合方式安全可行，更为微创。
Abstract:
ObjectiveTo prospectively study the clinical value of overlap anastomosis in laparoscopic left hemicolectomy.MethodsFrom May 2014 to October 2017, 53 cases of laparoscopic left hemicolectomy were randomly divided into two groups: intraabdominal anastomosis group (19 cases) and extraabdominal anastomosis group (34 cases). In the intraabdominal anastomosis group, the coloncolon sidetoside anastomosis (overlap anastomosis) was performed under the endoscope with linear cutting suture device, and the specimen bag was removed by enlarging the observation trocar incision to 4 cm. In the extraabdominal anastomosis group, the left ventral incision was enlarged to 4-6 cm, and the coloncolon endtoside anastomosis was completed in abdominal cavity. The operation time, intraoperative bleeding volume, 24hour pain scores, postoperative anal exhaust time, postoperative hospital stay, postoperative complications and operation costs were compared between the two groups.ResultsAs compared to the extraabdominal anastomosis group, the postoperative pain scores in the intraabdominal anastomosis group were lower ［(5.6±1.4) points vs. (6.7±1.5) points, t=-2.508, P=0.015］, but the operation costs were higher ［(2.8±0.4)×104 yuan, vs. (2.1±0.4)×104 yuan, t=5.952, P=0.000］. There were no significant differences in operation time, intraoperative bleeding volume, postoperative anal exhaust time, postoperative hospital stay or postoperative complications between the two groups (P>0.05).ConclusionLaparoscopic left hemicolectomy with overlap anastomosis is safe, feasible and minimally invasive.

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备注/Memo

备注/Memo:
基金项目：深圳市科技创新委员会基金项目（20160411113825854）**通讯作者，Email:zhongkeli@126.com
更新日期/Last Update: 2020-03-03