Comparison of the effects of laparoscopic assisted and open surgery in right colectomy / 中国基层医药

ABSTRACT

Objective To investigate the efficacy of laparoscopic assisted and open surgery for right colectomy.Methods 230 patients underwent right colectomy were selected,and they were randomly divided into laparoscopic group and laparotomy group according to the digital table,each group in 115cases.The laparoscopic group was treated with laparoscopic assisted operation.The laparotomy group was treated with open surgery.The complications after operation,the quality of life and follow up were compared between the two groups.Results The operation time,number of lymph node dissection and total cost of the laparoscopic group were (120.75 ± 28.20) min,(15.89 ± 3.83),(4.5 1 ±0.72) million,respectively,which of the l aparotomy group were (110.44 ± 23.58) min,(11.14 ± 4.01),(3.71 ±0.69) million,respectively,the differences were statistically significant (t =3.008,9.186,8.603,all P ＜ 0.01).The intraoperative blood loss and incision length of the laparoscopic group were (91.23 ± 14.85) mL and (5.85 ± 2.32) cm,respectively,which were significantly lower than those of the laparotomy group [(121.63 ± 12.32) mL,(15.05 ±7.72)cm,t =16.895,12.238,all P ＜ 0.01].The bowel exhaust time,fluid time,postoperative drainage time,postoperative analgesia time,postoperative catheterization time and hospitalization time of the laparoscopic group were (3.47 ± 1.55)d,(4.80 ±2.12)d,(6.31 ±3.21)d,(5.01 ± 1.75)h,(3.25 ± 1.07)d,(15.37 ±4.41)d,respectively,which were significantly shorter than those of the laparotomy group [(4.62 ± 1.68) d,(7.43 ± 2.58) d,(7.67 ±2.80)d,(9.51 ±3.54)h,(6.20 ±2.33) d,(22.62 ±5.39)d,t =16.895,12.238,5.395,8.446,3.424,12.220,12.338,11.163,all P ＜ 0.01].The incidence rate of complication in the laparoscopic group was 1.74％,which was significantly lower than 14.78％ in the laparotomy group(x2 =12.908,P ＜0.01).The scores of quality of life in the laparoscopic group were significantly higher than those in the laparotomy group(all P ＜ 0.01).The two groups were followed up for 9 months,the local recurrence,metastasis and other differences were not statistically significant (all P ＞ 0.05).Conclusion Laparoscopic assisted right colectomy has less wounded in patients,faster recovery after operation,lower incidence of complications,higher quality of life,but relatively expensive medical expenses.