A Study On The Clinical Application Of Single-incision Plus One Laparoscope In Radical Resection Of Right Colon Cancer

Objective: 1.To compare the short-term efficacy of Single-incision plus-one laparoscopic surgery(SILS+1)and Conventional Laparoscopic Surgery(CLS)in radical resection of right colon cancer.2.To explore the safety and feasibility of SILS+1 in radical resection of right colon cancer.Methods:Through a retrospective analysis,we collected a total of 75 patients with right colon cancer from January 2019 to December 2021 in the Department of Gastrointestinal Surgery of Yongzhou Central Hospital.The patients were divided into two groups according to the operation method,one group was the Single-incision plus-one laparoscopic surgery group(SILS+1,n=36),and the other group was the Conventional Laparoscopic Surgery group(CLS,n=39).The following data of patients were collected: clinical baseline data such as age,gender,BMI,tumor size,ASA classification,c TNM stage;perioperative indicators such as operation time,intraoperative blood loss,intraoperative carbon dioxide partial pressure,number of lymph nodes dissected,positive lymph nodes Number,total length of incision,postoperative pathological stage(p TNM),time to first get out of bed,time to first anal exhaust,time to first anal defecation,time to eat liquid food,days of hospitalization,hospitalization expenses;biochemical indicators such as preoperative albumin,Total protein,CRP,leukocytes,albumin,total protein,CRP,leukocytes on the 2nd postoperative day;and simulated VAS scores of pain 1 day,2 days,and 3 days after surgery in the two groups of patients,and postoperative complications were counted type,postoperative adjuvant therapy,postoperative follow-up.Results: There was no significant difference in gender,average age,BMI index,tumor size,ASA grade(I,II,III)and clinical stage(c TNM)between the two groups(P>0.05).There was no significant difference in the amount of bleeding,the number of lymph nodes dissected,the number of positive lymph nodes,the way of gastrointestinal reconstruction,and p TNM staging(P>0.05).The intraoperative partial pressure of carbon dioxide in the SILS+1 group was lower than that in the CLS group(P<0.05).The total incision length of SILS+1 group was significantly reduced compared with that of CLS group(p<0.05),The difference in the time of patients eating liquid food was small(P>0.05).The time of first out of bed activity,time of first fart,time of first defecation,hospital stay and total expenses in SILS+1 group were lower than those in CLS group,the differences were statistically significant(P<0.05).There was no significant difference in preoperative total protein,albumin,CRP and leukocyte indexes between the two groups(P>0.05);and the total protein and albumin after operation were lower than those before operation.The postoperative serum total protein and albumin in the SILS+1group were higher than those in the CLS group;CRP and leukocyte index increased compared with those before the operation,and the postoperative CRP in the SILS+1 group was lower than that in the CLS group,and the difference was statistically significant(P<0.05).Postoperative VAS scores of the two groups decreased day by day,with statistical significance(P<0.05).In all time periods,the SILS+1 score was lower than that of CLS group,and the difference was statistically significant(P<0.05).There were 2 cases of pulmonary infection,1 case of wound fat liquefaction,and 1 case of gastroparesis in the SILS+1 group,1 case of anastomotic leakage,1 case of paralytic ileus,1 case of incision infection,and 1 case of subcutaneous emphysema in the CLS group.The incidence of complications in the two groups were 11.11% and 10.26%,respectively,and the difference was not statistically significant(P>0.05).Conclusion:1.Compared with traditional laparoscopic surgery,single hole plus a laparoscopic surgery in the application of right colon cancer radical surgery with intraoperative carbon dioxide pressure rise low,short incision length,postoperative incision pain,pain points,postoperative gastrointestinal function recovery,postoperative inflammatory reaction,can shorten the hospital stay,reduce hospital costs.2.The application of single-incision plus one laparoscopic abdominal surgery in radical resection of right colon cancer is safe and feasible,which is worthy of further promotion and study by clinicians.