对比分析3孔法减孔腹腔镜与常规5孔法腹腔镜结直肠癌根治手术的临床疗效，评估3孔法手术的安全性、有效性及临床应用价值。

回顾性分析2024年1月至2025年3月在上海交通大学医学院附属瑞金医院普通外科行腹腔镜结直肠癌根治手术的84例患者临床病理资料，根据手术布孔方式分为3孔组(减孔组，n＝26)和5孔组(常规组，n＝58)。比较两组患者的一般临床资料、手术相关指标、肿瘤根治性指标及术后恢复、并发症发生等情况。

两组患者性别、年龄、体质量指数(body mass index，BMI)、NRS 2002营养风险评分、既往腹部手术史、术前血红蛋白水平、肿瘤位置等一般资料比较，差异均无统计学意义(P>0.05)，基线具有可比性。3孔组腹部切口总长度(5.2±1.2 cm)短于5孔组(7.8±0.8 cm)，两组比较差异有统计学意义(P<0.001)；术后首次排气时间3孔组(48.5±8.2 h)早于5孔组(56.8±10.5 h)，差异有统计学意义(P<0.001)；两组手术时间、术中出血量、肿瘤长径、病理T分期、淋巴结清扫数量等指标比较，差异无统计学意义(P>0.05)；两组术后并发症总发生率比较，差异无统计学意义(P>0.05)。

3孔法减孔腹腔镜结直肠癌根治手术在保证肿瘤根治性的前提下，具有腹部切口更短、术后胃肠功能恢复更快等优势，且不增加手术时间、术中出血量及术后并发症风险，手术安全性与有效性均得到保障，值得在腹腔镜技术成熟的临床中心推广应用。

To compare the clinical efficacy of three-port reduced-port laparoscopic surgery with conventional five-port laparoscopic surgery for radical resection of colorectal cancer, and to evaluate the safety, effectiveness, and clinical value of the three-port approach.

A retrospective analysis was conducted on the clinicopathological data of 84 patients who underwent laparoscopic radical resection for colorectal cancer at our institution between Jan. 2024 and Mar. 2025. According to the port configuration used during surgery, patients were divided into a three-port group (reduced-port group, n=26) and a five-port group (conventional group, n=58). Baseline characteristics, intraoperative parameters, oncological outcomes, postoperative recovery, and complication rates were compared between the two groups.

No significant differences were observed in baseline characteristics, including sex, age, BMI, NRS 2002 score, history of prior abdominal surgery, preoperative hemoglobin levels, or tumor location (all P>0.05), indicating good baseline comparability. The total abdominal incision length was significantly shorter in the three-port group(5.2±1.2 cm) compared to the five-port group(7.8±0.8 cm) (P<0.001). The time to first postoperative flatus was significantly earlier in the three-port group compared with the five-port group (48.5 ± 8.2 h vs. 56.8±10.5 h; P<0.001). There were no statistically significant differences in operative time, intraoperative blood loss, tumor size, pathological T stage, or number of harvested lymph nodes (all P>0.05). The overall postoperative complication rate was comparable between the two groups (P>0.05).

The three-port reduced-port laparoscopic approach for radical resection of colorectal cancer achieves comparable oncological outcomes and safety to the conventional five-port method. It offers distinct advantages in terms of shorter incision length and faster recovery of gastrointestinal function, without increasing operative time, blood loss, or complication risk. This technique is safe, effective, and minimally invasive, and represents a promising surgical option worthy of broader clinical adoption in high-volume centers with established laparoscopic expertise.