应用超能剪进行腹腔镜右半结肠切除术36例  

Experience in laparoscopic right hemicolectomies using super shear system: report of 36 cases

作　　者：冯泽荣[1] 梁萍[1] 吴东波[1] 邓洪强[1] 刘杨桦[1] 吴鸿根[1] 何纯刚[1] 刘超[1] 林家威[1] 王文美[1] 潘云[1] 陈荣[1] 

机构地区：[1]广西壮族自治区人民医院普通外科,南宁530021

出　　处：《中国临床新医学》2015年第1期4-6,共3页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西科学研究与技术开发计划项目(编号:桂科攻10124001A-53);广西医疗卫生适宜技术研究与开发项目(编号:S201421-01)

摘　　要：目的 探讨应用超能剪进行腹腔镜右半结肠切除术的安全性和可行性。方法 回顾性分析2010-12~2014-08应用超能剪进行腹腔镜右半结肠切除36例临床资料。结果 36例中,升结肠癌17例,结肠肝曲癌13例,盲肠癌6例。手术均顺利完成,手术时间为（161.3±55.7）min,术中出血量为（86.7±38.5）ml,术后肛门排气时间为（3.2±0.8）d,术后腹腔引流量为（290.2±67.3）ml。无输尿管损伤、吻合口瘘等并发症。清扫淋巴结5~21枚,平均12.6枚。术后获随访29例,时间为1~42个月,中位随访时间为23个月。失访7例。1例拒绝化疗的Dukes C期患者于术后9个月结肠镜检发现吻合口局部复发并经病理证实;2例Dukes C期患者分别于术后16个月（未接受化疗者）和23个月（接受正规化疗者）腹部B超及CT发现腹部包块,后经再手术病理证实为局部复发;1例Dukes C期患者于术后6个月（中途退出化疗者）B超及CT发现肝多发性转移癌。其余患者随访未见复发和转移情况。结论 应用超能剪进行腹腔镜右半结肠切除安全可行,超能剪能够胜任腹腔镜右半结肠癌的根治手术。Objective To study the safety and feasibility of Super Shear System used in laparoscopic right hemieolectomy. Methods The clinical data of 36 patients undergoing laparoscopie right hemieoleetomies using Super Shear System were analysed retrospectively between December 2010 and August 2014. Results Thirty-six eases were selected in this study including 6 cases of cecum cancer, 17 cases of ascending cancer and 13 cases of cancer of he- parle flexure of colon and all patients were performed successfully on surgery. The average operative time was （161.3 ＋- 55.7 ）min. The mean volume of bleeding was （86.7 -38.5 ）ml. Postoperative time of bowel gas passage was （3.2 _＋ 0. 8 ） d. The volume of abdominal drainage was （290. 2 ＋- 67. 3 ） ml. No cmplieations were experienced, such as ure- teral injury, anastomotic leakage, and so on. The number of lymph node dissection was 5 -21 and the mean was 12. 6. The time of following up ranged from one month to forty-two months and the median value was twenty-three. seven eases were lost to follow-up. One case with stage Dukes C suffered anastomotic recun-ence which was tbund by endoscopic examination and was confirmed by pathologic examination at postoperative ninth month, who refused any chemotherapy. Abdominal lumps were found in two cases with stage Dukes C by B-uhrasound and CT scan at postop- erative sixteen month and twenty-three months, which were confirmed to be recurrent tumors. One ease refused chemotherapy and another ease received normal chemotherapy accordingly. Multiple metastasis in liver was tound by B-ultrasound and CT scan in one case with stage Dukes C, who quited chemotherapy after two courses of treatments, Recurrence and metastasis were not found in other patients during following up. Conclusion It is safe and feasible to perform laparoscopic right hemicolectomy using super shear system and super shear system is competent for laparoscopic right hemicolectomy.

关 键 词：腹腔镜手术 右半结肠切除术 腹腔镜手术器械 超能剪 

分 类 号：R735.35[医药卫生—肿瘤]