完整结肠系膜切除在腹腔镜辅助右半结肠癌根治术中的应用  

Complete mesocolic excision in laparoscopy-assisted right hemicolon carcinoma radical resection

作　　者：邱兴烽[1] 叶志坚[1] 闫峰[1] 林立[1] 袁思波[1] 丁志杰[1] 王振发[1] 齐忠权[1] 刘忠臣[1] 

机构地区：[1]厦门大学附属中山医院胃肠外科,福建省361004

出　　处：《中华普通外科杂志》2012年第3期213-215,共3页Chinese Journal of General Surgery

摘　　要：目的探讨完整结肠系膜切除在腹腔镜辅助右半结肠癌根治术中的应用。方法统计分析厦门大学附属中山医院胃肠外科2010年6月至2011年7月实施的36例腹腔镜辅助全右半结肠系膜切除术的手术方法和临床效果。结果36例均顺利完成手术，无中转开腹。平均手术时间为（134±22）min；平均术中出血量为（95±53）ml；平均检出淋巴结15．7枚／例；术后排气时间平均为（3．1±1．2）d；术后并发症率为17％（6／36），其中淋巴瘘4例，肺部感染1例，术后出血1例。结论腹腔镜辅助完整右半结肠系膜切除治疗右半结肠癌是安全有效的，可以达到系膜和淋巴组织切除的最大化。其远期疗效有待进一步观察。Objective- To evaluate complete mesocolic excision in laparoscopy-assisted right hemicolon carcinoma radical resection. Methods Laparoscopy-assisted right hemicolon carcinoma radical resection with complete right-side mesocolic excision was performed in 36 cases between June 2010 and July 2011 at Zhongshan Hospital, Xiamen University. Results The operations were completed successfully without conversion to open surgery. The mean operative time was （134 ± 22） min. The blood loss was （95 ± 53 ） ml. The median number of total lymph nodes removed was 15.7. The average time for passage of flatus was （3.1 ± 1.2） d. The postoperative complications were observed in 6 of 36 cases （ 17% ） including lymphatic fistulas in 4 patients, pulmonary infection in 1 patient and postoperative bleeding in 1 case. Conclusions Laparoscopy-assisted complete right-side mesocolic excision can be successfully performed for right hemicolon carcinoma, and the lymphoid tissue could be eliminated maximally. The long-term results need further evaluation.

关 键 词：结肠肿瘤 腹腔镜检查 结肠系膜 

分 类 号：R735.35[医药卫生—肿瘤]