Clinical analysis of the application of hand-assistant laparoscopy or total laparoscopy in radical right colectomy / 中国综合临床

ABSTRACT

Objective To investigate the clinical application value of hand-assistant laparoscopy and total laparoscopy in radical right colectomy.Methods Five hundred and twenty-four patients were selected as our subjects who performed by hand-assistant laparoscopic radical right colectomy (213 cases) or total laparoscopic radical right colectomy (293 cases) in colon cancer therapy.The operation durations,bleeding volumes,postoperative pain scores,postoperative draining volumes,recovery time of gastrointestinal function,hospitalization times,hospitalization expenses,postoperative complications and cosmetic satisfactory scores were recorded and compared.Results The operation durations,bleeding volumes,postoperative draining volumes in hand-assistant laparoscopic group were (112.4±52.9) min,(105.6 ± 49.5) ml,(28.6± 15.7) ml,lower than those in total laparoscopic group((148.5±61.7) min,(171.5±72.4) ml,(28.6±15.7) ml;P=0.032,0.041,0.039).The recovery time of gastrointestinal function of hand-assistant laparoscopic group were (69.4±21.8) h,longer than total laparoscopic group ((53.4 ± 21.7) h;P =0.008).The hospitalization times,hospitalization expenses,postoperative complications of hand-assistant laparoscopic group were as same as total laparoscopic group(P＞0.05).Hand-assisted laparoscopic group mild pain in 35 cases,121 cases of moderate and severe 75 cases;Total 96 cases of mild pain in laparoscopic group,146 cases of moderate and severe in 51 cases,the difference was statistically significant(P=0.027).Beauty score incision of laparoscopic group was higher than in the whole hand-assisted laparoscopic group,the difference was statistically significant ((4.3 ± 0.9) score vs.(2.4±0.6) score;P=0.002).Conclusion Hand-assistant laparoscopic radical right colectomy is convenient and more quickly for operation.Total laparoscopic radical right colectomy has advantage in terms of less injury and the patients are more satisfactory.For practiced operators,total laparoscopic radical right colectomy is recommended cosmetic satisfactory score.