Open Right Hemicolectomy:Lateral to Medial or Medial to Lateral Approach?
Open Right Hemicolectomy:Lateral to Medial or Medial to Lateral Approach?
复制标题
开放性右半结肠切除术：从外侧到内侧还是从内侧到外侧入路？
DOI：
10.1371/journal.pone.0145175
复制
发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Xu J
中科院分区：
文献类型：
--
作者：
Xu P;Ren L;Zhu D;Lin Q;Zhong Y;Tang W;Feng Q;Zheng P;Ji M;Wei Y;Xu J
目前，尚无已发表的研究比较了开放性右半结肠切除术中内侧-外侧入路（MA）和外侧-内侧入路（LA）的临床结局。因此，本研究旨在评估这些方法中的一种是否比另一种有任何潜在的好处。对2008年6月至2012年6月期间接受开放性右半结肠切除术且经病理学证实符合合格标准的所有患者进行了回顾性研究。根据倾向评分将人群分为MA组和LA组。我们比较了两组患者的人口统计学和临床特征变量，并评估了短期和长期结局。共评价了450例患者（MA，n = 150; LA，n = 300）。MA组的手术时间（MA，138.4 min vs. LA，166.2 min; P <0.05）和失血量（MA，52.0 mL vs. LA，62.6 mL; P <0.05）显著较低。两组之间在收获的淋巴结数量和肿瘤学结局方面没有观察到差异。III期结肠癌的进一步亚组分析显示，MA组的淋巴结回收率显著高于MA组（MA，18. 8 vs. LA，16.0; P = .028）。两组间其他变量无差异。与LA相比，MA减少了手术时间和失血量。因此，我们得出结论，与LA相比，MA在右侧结肠癌开放性右半结肠切除术中提供了短期获益。
Currently, no published studies have compared the clinical outcomes of the medial-to-lateral approach (MA) and lateral-to-medial approach (LA) for open right hemicolectomy. Thus, the present study aimed to assess whether one of these approaches has any potential benefits over the other. A retrospective study was performed of all patients who underwent open right hemicolectomy with pathologically confirmed disease who met the eligibility criteria between June 2008 and June 2012. The population was divided into an MA group and an LA group by propensity scoring. We compared patient demographic and clinical characteristic variables between the two groups and assessed short-term and long-term outcomes. A total of 450 patients (MA, n = 150; LA, n = 300) were evaluated. The operation time (MA,138.4 minutesvs.LA,166.2 minutes; P < .05) and blood loss (MA,52.0mL vs. LA,62.6mL; P < .05)were significantly lower in the MA group. No differences in the number of harvested lymph nodes and oncologic outcomes were observed between the two groups. Further subgroup analysis for stage III colon cancer revealed that the MA group had significantly more retrieved lymph nodes (MA,18.8vs. LA,16.0; P = .028). There were no differences in other variables between the two groups. The MA reduced operative time and blood loss compared with the LA. We thus concluded that the MA provided short-term benefits compared with the LA in open right hemicolectomy for right-sided colon cancer.