[1]薛吓娟 郭银枞** 简超① 沈祁远 杨愈刚 姚开源 曾群章.左半与右半结肠癌实施加速康复外科的比较[J].中国微创外科杂志,2021,01(9):812-816.
　Xue Xiajuan*,Guo Yincong*,Jian Chao,et al.Comparison Between Left and Right Colon Cancer Surgery With Implementation of Enhanced Recovery After Surgery[J].Chinese Journal of Minimally Invasive Surgery,2021,01(9):812-816.
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左半与右半结肠癌实施加速康复外科的比较()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年9期
页码:
812-816
栏目:
临床研究
出版日期:
2021-09-25

文章信息/Info

Title:
Comparison Between Left and Right Colon Cancer Surgery With Implementation of Enhanced Recovery After Surgery
作者:
薛吓娟 郭银枞** 简超① 沈祁远 杨愈刚 姚开源 曾群章
（福建医科大学附属漳州市医院结直肠外科，漳州363000）
Author(s):
Xue Xiajuan*;  Guo Yincong*;  Jian Chao;  et al.
*Department of Colorectal Surgery, Zhangzhou Municipal Hospital of Fujian Medical University, Zhangzhou 363000, China
关键词:
结肠癌; 快速康复外科; 肿瘤位置
Keywords:
Colorectal cancer; Enhanced recovery after surgery; Tumor location
文献标志码:
A
摘要:
目的探讨根据结肠癌位置的不同制定个体化加速康复外科（enhanced recovery after surgery，ERAS）方案的可行性。方法回顾性分析2019年1~12月我科完成的195例腹腔镜结肠癌手术，统一实施ERAS管理，根据肿瘤部位不同分为右半结肠组（n=92）和左半结肠组(n=103)，比较2组排气时间、进食全流质时间、排便时间、术后住院时间以及术后并发症（出血、乳糜漏、吻合口漏、腹腔感染、切口感染、肺部感染、肠梗阻、静脉血栓、尿潴留等）。结果左半结肠组术后排气时间、术后进全流质食时间明显早于右半结肠组［（1.5±0.4）d vs.（2.2±0.5）d，t=10.485，P=0.000；（2.0±0.3）d vs.（2.7±0.5）d，t=10.717,P=0.000］，左半结肠组术后住院时间明显长于右半结肠组 ［（7.4±1.9)d vs.（6.6±1.9）d，t=-3.112，P=0.002］。2组患者术后排便时间差异无统计学意义［（5.5±0.9）d vs.（5.4±0.5）d，t=-1.838，P=0.068］。右半结肠组乳糜漏发生率较高［7.6%（7/92） vs. 1.0%(1/103)， χ2=3.866，P=0.049］，左半结肠组吻合口漏［5.8%（6/103） vs. 0%，Fisher精确检验，P=0.030］和感染相关并发症发生率［9.7%（10/103）vs. 2.2%(2/92)， χ2=4.777，P=0.029］明显高于右半结肠组。结论根据肿瘤位置不同，结肠癌实施ERAS的结果存在差异，有必要按照肿瘤位置制定个体化的ERAS方案。
Abstract:
ObjectiveTo explore the implementation feasibility of enhanced recovery after surgery (ERAS) in patients with colon cancer according to different tumor locations.MethodsA retrospective analysis was made on 195 cases of laparoscopic colon cancer surgery in our hospital from January to December 2019. The ERAS was administered. According to the location of the tumor, there were 92 cases in the right colon group and 103 cases in the left colon group. The exhaust time, time to taking full fluid, defecation time, postoperative hospital stay, and postoperative complications (bleeding, chylous fistula, anastomotic leakage, abdominal infection, wound infection, pulmonary infection, intestinal obstruction, venous thrombosis, and urinary retention) were compared between the two groups.ResultsThe exhaust time and time to taking full fluid were significantly shorter in the left colon group than those in the right colon group ［(1.5±0.4) d vs. (2.2±0.5) d, t=10.485, P=0.000; (2.0±0.3) d vs. (2.7±05) d, t=10.717, P=0.000］, and the postoperative hospital stay was significantly longer in the left colon group than that in the right colon group ［(7.4±1.9) d vs. (6.6±1.9) d, t=-3.112, P=0.002］. There was no difference in defecation time between the two groups ［(5.5±09) d vs. (5.4±05) d, t=-1.838, P=0.068］. The incidence of chylous fistula of the right colon group was higher ［7.6% (7/92) vs. 1.0% (1/103), χ2=3.866, P=0.049］, and the incidence of anastomotic fistula of the left colon group was higher ［58% (6/103) vs. 0%, Fisher’s exact test,P=0.030］, and the incidence of infectionrelated complications of the left colon group was higher ［9.7% (10/103) vs. 2.2% (2/92), χ2=4.777, P=0.029］ than those of the right colon group.ConclusionsThere are differences in the results of ERAS for colon cancer according to the tumor location. It is necessary to formulate an individualized ERAS scheme according to the tumor location.

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备注/Memo

备注/Memo:
基金项目：福建省漳州市自然科学基金（zz2019J20）;福建医科大学启航基金（2018QH1208）**通讯作者，Email:xuexjzzsyy@163.com ①内科重症监护室
更新日期/Last Update: 2021-12-09