右半结肠癌腹腔镜下完整结肠系膜切除的临床效果  

Effect of iaparoscopic complete mesocolic excision （CME） for right colon cancer

作　　者：叶甫波[1] 朱雄文[1] 吴贵阳[1] 陈再平[1] 金晓燕[1] 

机构地区：[1]台州市立医院胃肠外科,浙江省台州318000

出　　处：《中国基层医药》2018年第5期557-560,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省医学会临床科研基金项目（2013ZYC-A138）,浙江省台州市椒江区科技局立项（153048）

摘　　要：目的探讨右半结肠癌腹腔镜完整结肠系膜切除的临床效果。方法将45例腹腔镜右半结肠癌完整系膜切除患者作为研究组（腹腔镜组），选取同期40例右半结肠癌开腹完整结肠系膜切除（CME）作为对照组（开腹组），观察两组临床治疗效果。结果腹腔镜组45例患者均顺利完成手术，按照手术质量等级判定系统判定优40例。腹腔镜组术后肛门排气时间（3．43±0．72）d，低于开腹组的（4．10±0．99）d（P=0．039，P〈0．05），下床活动时间（3．39±0．66）d，明显短于开腹组的（4．20±0．79）d（P=0．005，P〈0．05），手术时间（160．93±20．91）min，较开腹组的（103．00±24．29）min明显延长（P=0．000，P〈0．05）。腔镜组切除淋巴结数目（23．16±8．21）个，略高于开腹组的（19．06±7．48）个，但组间差异无统计学意义（P=0．102，P〉0．05）。腹腔镜组术后并发症发生率为13．33％，低于开腹组的22．50％，两组差异无统计学意义（P=0．268，P〉0．05）。结论腹腔镜右半结肠癌完整结肠系膜切除是安全可行的。Objective To evaluate the experience of laparoscopic complete mesocolic excision （CME） for right colon cancer. Methods 45 patients with fight colon cancer underwent laparoscopic CME were selected as research subjects（ laparoscopy group）, and 40 patients with right colon cancer underwent open CME were selected as control group（ open group）. The clinical effects of the two groups were observed. Results All the 45 cases were successfully performed with laparoscopie CME and 40 specimens were evaluated pathologically as mesocolic plane surgery. The average time for passage of flatus in the laparoscopy group [ （ 3.43 ± 0. 72 ） d ] was less than that in the open group [ （ 4.10 ±0. 99） d,P = 0. 039,P 〈 0.05 ]. The average time of leaving bed [ （3.39 ±0. 66） d ] in the laparoseopy group was significantly less than that in the open group [ （4.20 ±0. 79 ） d, P = 0.005, P 〈 0. 05 ]. The mean operative time of the laparoseopy group [ （ 160.93±20.91 ） min ] was longer than that of the open group [ （ 103. 00±24.29 ） min,P = 0.000,P 〈0. 05]. The average number of total lymph nodes removed of the laparoscopy group [ （23.16 ±8.21 ）] was higher than that of the open group [ （19.06±7.48 ） ], but the difference was not statistically significant between the two groups （ P = 0. 102, P 〉 0.05 ）. The overall postoperative complication rate of the laparoscopy group was 13.33% ,which was lower than 22.50% of the open group,but the difference was not statistically significant between the two groups （P = 0.268 ,P 〉 0.05 ）. Conclusion Laparoscope complete mesocolic excision for right colon cancer is safe and feasible.

关 键 词：右半结肠癌 腹腔镜 完整结肠系膜切除 

分 类 号：R735.35[医药卫生—肿瘤]