作者：刘彦合，姬安龙，傅祥炜，曾祥勇

单位：海南医学院第二附属医院 普通外科， 海南 海口 570311

Authors: Liu Yanhe，Ji Anlong，Fu Xiangwei，Zeng Xiangyong

Unit: General Surgery，the Second Affiliated Hospital of Hainan Medical University，Haikou 570311，Hainan，China

摘要：

关键词：腹腔镜右半结肠根治术； 结直肠癌； 中间入路； 侧方入路； 早期肠内营养支持

Abstract：

Objective To investigate the effect of laparoscopic radical right hemicolectomy combined with early enteral nutrition support on postoperative rehabilitation of patients with colorectal cancer. Method A total of 180 patients with colorectal cancer treated in the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2021 were retrospectively selected as research objects. According to the treatment methods，they were divided into the middle approach group (n=99) and the side approach group (n=81). The middle approach group received the middle approach laparoscopic radical resection of the right half colon，and the side approach group received the lateral approach laparoscopic radical resection of the right half colon. Perioperative indexes，postoperative immune function，nutritional status，postoperative recovery and postoperative complications were compared between the two groups. Result The operation time and hospital stay in the middle approach group were shorter than those in the lateral approach group(P<0.05). The levels of ALB，PA，TRF and HB in the intermediate approach group were higher than those in the lateral approach group 7 days after surgery (P<0.05).The levels of IgA，IgM，IgG，CD3+，CD4+ and CD8+T lymphocytes in the intermediate approach group were higher than those in the lateral approach group 7 days after surgery (P<0.05).The recovery time of intestinal sound，the first time of oral feeding，the first time of getting out of bed and the first time of exhaust in the middle approach group were all shorter than those in the side approach group (P<0.05). The total complication rate of the intermediate approach group was 8.08%，which was lower than that of the lateral approach group (18.51%) (P <0.05). Conclusion In patients with colorectal cancer，laparoscopic radical resection of the right half colon through the middle approach combined with early enteral nutrition support therapy can effectively reduce intraoperative blood loss， improve immune function and nutritional status， quickly restore intestinal function， and promote postoperative rehabilitation with fewer complications.

Key Words:  Laparoscopic radical resection of the right colon; Colorectal cancer; Middle approach; Side approach; Early enteral nutrition support