腹腔镜辅助右半结肠癌根治术27例临床分析  

Laparoscopy-assisted right hemicolectomy for colon carcinoma:analysis of 27 cases

作　　者：陈勇[1] 华颂文[1] 段伦喜[2] 雷三林[2] 易文君[2] 苗雄鹰[2] 钟德玝[2] 

机构地区：[1]中南大学湘雅二医院普外科微创中心,湖南长沙410011 [2]中南大学湘雅二医院普外科

出　　处：《徐州医学院学报》2008年第6期399-402,共4页Acta Academiae Medicinae Xuzhou

摘　　要：目的探讨腹腔镜辅助右半结肠癌切除的手术方法和手术的适应证。方法对27例腹腔镜辅助右半结肠癌切除手术患者的临床资料进行回顾性分析。结果24例顺利完成腹腔镜辅助右半结肠癌根治术,3例中转开腹（其中1例肿瘤侵犯十二指肠,2例回盲部肿瘤〉8 cm）,无手术死亡。平均手术时间（160±30）min、平均出血量（110±30）ml,平均术后住院（9±2）天。1例术后第2天肺部感染,1例术后第5天出现不完全性肠梗阻。24例完成腹腔镜手术患者随访6~36个月,其中2例发生双肺部转移,1例发生肝转移,1例发现Trocar穿刺处肿瘤种植并腹腔内远处转移。结论只要严格掌握手术适应证,熟练应用腹腔镜技术,腹腔镜辅助右半结肠癌根治术是安全、可行的,能够达到与开腹手术相当的效果。Objective To explore the modified surgical technique and indication of laparoscopy - assisted fight hemieolectomy for colon carcinoma. Methods A retrospective analysis was made on 27 patients having undergone laparoscopy-assisted fight hemicolectomy for colon carcinoma. Results The laparoscopic surgery was successfully performed in 24 cases, but was converted to open surgery in the other 3 cases （due to duodenal involvement in 1 case, and the diameter of ileoeecal tumor 〉 8 cm in 2 cases）. No patients died on table. The mean operation time was （ 160±30） min, the blood loss was （ 110±30） ml, the mean time of hospital stay was （9±2） days after operation. Pulmonary infection was found in 1 patient on the second postoperative day, incomplete intestinal obstruction in another patient on the 5th postoperative day. Follow - up of 24 cases for 6-36 months revealed 2 eases of lung metastasis, 1 liver metastasis, 1 abdominal metastasis and 1 tumor cell seeding at the Trocar site. Conclusions Laparoscopy - assisted fight hemicolectomy for colon carcinoma is safe and feasible, producing an efficacy equal to that of a routine open abdominal surgery.

关 键 词：结肠肿瘤 腹腔镜 右半结肠切除术 

分 类 号：R656.9[医药卫生—外科学]