腹腔镜右半结肠癌CME根治术与策略  

Laparoscopic complete mesocolic excision in treating right colon cancer and clinical strategy

作　　者：苏向前[1] 张成海[1] Su Xiangqian Zhang Chenghai. Key laboratory of Carcinogenesis and Translational Research(Ministry of Education）, Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital ＆ Institute, Beijing 100142, China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所胃肠肿瘤中心四病区恶性肿瘤发病机制及转化研究教育部重点实验室,100142

出　　处：《中华普外科手术学杂志（电子版）》2017年第2期95-98,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金项目(81272766;81450028;81672439);北京市自然科学基金(7162039);北京市医院管理局临床医学发展专项经费资助(XM201309);北京大学"985工程"三期临床医院合作专项~~

摘　　要：相对传统右半结肠癌手术,完整全结肠系膜切除(CME)手术可以提供高质量的手术标本和更多的淋巴结清扫数目。因此,腹腔镜右半结肠癌CME根治术既结合了腔镜手术的微创性又兼具CME手术的肿瘤根治性。右半结肠因解剖结构复杂、比邻器官众多、血管变异等因素,手术难度较大。高质量腹腔镜右半结肠癌CME手术的完成需要术者丰富的腹腔镜操作经验与技巧、扎实的解剖学知识和助手的良好配合。腹腔镜右半结肠癌CME手术目前没有标准的手术方式,因此本文拟从右半结肠CME概念、手术适应证、手术步骤、外科操作平面及中央组淋巴结清扫边界等方面介绍腹腔镜右半结肠CME手术的相关内容及注意事项。Complete mesocolic excision（CME）for colonic cancer offers a surgical specimen of higher quality,with higher number of lymph nodes compared to conventional colectomy.Laparoscopic CME in treating right colon cancer has advantages of minimal invasion and better prognosis.Laparoscopic surgery of right colon cancer is still a challenge because of complex anatomy,adjacent organs and variation of blood vessels.High quality Laparoscopic CME for right colon cancer requires the extensive laparoscopic experience and skills,solid knowledge of anatomy and tacit cooperation.Currently,the surgical approach of laparoscopic CME in right colon cancer is not uniform.This article introduced the contents of laparoscopic CME in right colon cancer and precautions,including the concept of CME,the indications and contraindications,surgical procedure,operation plane and the boundaries of central lymph node dissection.

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]