全结肠系膜切除术在腹腔镜与开腹右半结肠癌根治术中应用的对比研究  被引量:38

Comparative study of the application with complete mesocolic excision in laparoscopic and open surgery in right colon resection

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作  者:黄建国[1] 刘乃青[1] 丁元升[1] 田相安 孙淑香[1] 张京雨[1] 周忠晋[1] 孙钦立[1] 

机构地区:[1]临沂市沂水中心医院普外一科,山东临沂276400

出  处:《中国现代普通外科进展》2015年第3期185-188,共4页Chinese Journal of Current Advances in General Surgery

摘  要:目的:探讨完整全结肠系膜切除(C M E)在腹腔镜右半结肠癌根治术中应用的可行性。方法:统计2010年3月—2014年1月67例在C M E概念下腹腔镜组(35例)与开腹组(32例)右半结肠癌根治术的临床疗效并进行比较分析。结果:两组手术顺利,排除中转开腹患者。腹腔镜手术组与开腹手术组:平均手术时间分别为(128.0±5.4)m in、(125.5±6.6)m in;平均术中出血量分别为(77.8±13.9)m L、(77.1±15.4)m L;平均检出淋巴结分别为15.9枚/例、16.0枚/例;术后平均排气时间分别为(2.9±0.9)d、(2.8±0.9)d;平均住院日分别为(9.6±1.0)d、(13.6±1.3)d;术后并发症率分别为18.8%(6/32)、20.0%(7/35)。结论:全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。腹腔镜与开腹手术相比疗效无明显差别。Objective: To explore the feasibility of complete mesocolic excision in laparoscopic right colon resection. Methods: Statistics the date of clinical efficacy in 67 patients,who had accepted right colon resection with laparoscopic Surgery or Open surgery by the complete mecocolic excision principlesi, and these date is comparatively analyzed. Results: The group of the laparoscopic surgery is 32 cases, surgery successfully,without converted to open. Laparoscopy group andlaparotomy group: average operative time was(128.0±5.4)min,(125.5±6.6)min; average blood loss was(77.8±13.9)mL,(77.1±15.4)mL; average detection lymph nodes were 15.9 / patients,16.0/case; average postoperative discharge time was(2.9 ±0.9)d,(2.8±0.9)d; average hospital stay was(9.6 ±1.0)d,(13.6 ±1.3)d; the rate of postoperative complications was 18.8%(6/32),20.0%(7/35). Conclusion: The complete mesocolic excision in right colon resection is safe and effective, and can excision the mesocolon and lymphoid tissue maximally. The clinical efficacy is no significantdifferences in laparoscopy group and laparotomy group.

关 键 词:结肠肿瘤 腹腔镜 全结肠系膜切除 

分 类 号:R735.35[医药卫生—肿瘤]

 

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