腹腔镜辅助右半结肠切除术的临床研究  

Clinical analysis of laparoscopic-assisted right hemicolectomy

作　　者：刘炜[1] 曹胜华[1] 邹林[1] 

机构地区：[1]湖北省宜昌市第一人民医院普外科,湖北宜昌443000

出　　处：《中国当代医药》2013年第13期181-182,共2页China Modern Medicine

摘　　要：目的探讨腹腔镜下右半结肠癌切除术的根治性、安全性、可行性及远期临床效果。方法应用腹腔镜行右半结肠癌切除术64例,肠系膜分离、肠系膜血管的结扎和淋巴清扫均在腹腔镜下操作,肠管的切除与吻合经由腹壁小切口在腹腔外完成。结果本组患者无中转开腹,无术中死亡。手术时间为160～250min,平均180min。清扫淋巴结数目(16.0±7.0)枚。术中出血(90.0±50.0)mL,术后进食时间、恢复下床活动、肠道排气及术后住院天数分别为(33.0±7.0)h、(21.0±7.0)h、(44.0±14.0)h、(9.0±3.0)d。术后并发假性肠梗阻1例,经1周保守治疗康复。术后64例随访3～48个月,平均20个月,随访期内无穿刺孔肿瘤种植,无死亡患者,局部复发1例,肝转移1例。结论腹腔镜下右半结肠癌根治具有微创、安全、康复快、肿瘤清扫彻底等优点,值得广泛应用。Objective To evaluate the safety, feasibility and therapeutic effects of laparoscopic-assisted right hemieolectomy. Methods Sixty-four patients with right-sided colonic carcinoma underwent laparoscopic-assisted right to extended right hemieoleetomy at our hospital. The separation of the mesentery, ligation of the mesenterie vessels and lymphectomy were completely performed under laparoscopy. The resection of the right colon and end-to-end anastomosis of the residual bowels were performed through a small incision in the abdomen. Results The operations were completely managed by laparoseopy in all the cases without conversion to open surgery, there was no death in operation or postoperation. The operation time was 160-250 min （mean 180 min）. A mean of （16.0±7.0） lymph nodes were reseeted, the mean volumes of intraoperative bleeding were （90.0±50.0） mL the mean time of liquid diet was （33.0±7.0） h, the mean time of activity was （21.0±7.0） h, the mean time of anal aerofluxus was （44.0±14.0） h, the mean postoperative hospital stay was （9.0±3.0） d. One case complicated with intestinal obstruction, recovered with conservative treatment in one week. Median follow-up was 20 months （range, 3 to 48 months）. During follow-up period, live metastasis was observed in 1 case, and 1 case of local recurrence was observed. No tumor implantation occurred at the site of the incision or puncture site in this series. Conehmion These results suggest that laparoscopically assisted right hemieolectomy of the right colon has advantages of safe, and completely tumor dissection, shorter resume time. it is worthy of clinical application.

关 键 词：腹腔镜 右半结肠切除 结肠癌 临床研究 

分 类 号：R735.35[医药卫生—肿瘤]