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1、不同入路腹腔镜根治术治疗右半结肠癌的临床效果［摘要］目的研究不同入路腹腔镜根治术(LRO)治疗右半结肠癌(RCC)的临床效果。方法将2013年1〜12月在成都医学院第一附属医院接受LR0治疗的RCC患者88例纳入本研究，按照随机数字表法分为屮间组(n=44)与侧方组(n二44)。中间组取中间入路，侧方组取侧方入路。观察两组术中出血量、淋巴结清扫数目、手术时间、术后排气时间、术后镇痛时间及住院时间，两组术前及术后7dCD3+、CD4+、CD8+、CD4+/CD8+水平，两组术后7d血清Polo样激酶l(Plkl)、胸腺激酶(TK1)、凋
2、亡抑制因子(Livin)、X连锁凋亡抑制蛋白(Xiap)等指标及术后并发症。结果中间组术中出血量、手术时间、术后排气时间均大于侧方组，差异有统计学意义(P0.05)o结论侧方入路LRO治疗RCC创伤小，手术时间短，病灶切除彻底，对患者细胞免疫影响小，术后恢复快。［关键词］腹腔镜根治术；右半结肠癌；屮间入路；侧方入路；疗效［中图分类号］R735.3［文献标识码］A［文章编号］1674-4721(2016)09(a)-0080-04［Abstract］ObjectiveTostudytheclinicaleffectoflaparosco
3、picradicaloperation(LRO)ofdifferentoperationapproachintreatingrightcoloncancer(RCC).Methods88casesofpatientswithRCCwhoacceptedLROtreatmentinourhospitalfromJanuarytoDecember2013wereseiectedanddividedintointermediateapproachgroup(n=44)andlateralapproachgroup(n二44)accordin
4、gtotherandomnumbertablemethod.Intermediateapproachwasadoptedinintermediateapproachgroup,andlateralapproachwasadoptedinlateralinlermediategroup.Theintraoperatvebloodsoss,numberoflymphnodedissection,timeofoperation,postoperativeevacuationtime,postoperativeanalgesictimeand
5、hospitalizationtimeofthetwogroupswereobserved.Besides,thelevelsofCD3+,CD4+,CD8+andCD4+/CD8+in7daysbeforeandafteroperation,theserumpolo-likekinase1(Plkl),thymidinekinase(TK1),Livin,XLinkedInhibitorofApoptosisProtein(XIAP)andotherindexesin7daysafteroperation,andpostoperat
6、ivecomplicationsofthetwogroupswereobserved.ResuItsTheintraoperatvebloodsoss,timeofoperationandpostoperativeevacuationtimeofintermediateapproachgroupweregreaterthanthoseoflateralapproachgroup,andthedifferencewasstatisticallysignificant(P0.05)•ConclusionLateralapproachLRO
7、treatingRCChaslesstrauma,shortoperationtime,completefocalexcision,smallinfluenceoncellularimmunityofthepatients,andrapidpostoperativerecovery.[Keywords]Laparoscopicradicaloperation；Rightcoloncancer；Intermediateapproach；Lateralapproach；Curativeeffect右半结肠癌(rightcoloncance
8、r,RCC)为临床常见胃肠系统恶性肿瘤，每年新增患者约800万例，为所冇癌症患者的1/10左右［1］。在RCC的临床治疗上，传统上多行开腹手术治疗［2］。尽管开腹治疗RCC疗效较好，但却存在着创伤大，术后并发症多，术后恢
