腹腔镜右半结肠癌根治术的难点与争议  

The difficulties and controversies of laparoscopic right hemicolectomy

作　　者：郑民华[1,2] 马君俊[1,2] Zheng Minhua;Ma Junjun(Department of Gastrointestinal Surgery,Rui-Jin Hospital,Shanghai Jiao-Tong University School of Medicince;Shanghai Minimal Invasive Surgery Center,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院胃肠外科 [2]上海市微创外科临床医学中心

出　　处：《中华普外科手术学杂志（电子版）》2018年第3期181-184,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：促进市级临床技能与临床创新能力三年行动计划:(16CR1011A);上海市科委启明星计划项目(96QB14019);国家高新技术研究发展计划项目(2012AA021103)

摘　　要：腹腔镜右半结肠癌根治术的手术技术已经非常成熟。但在淋巴清扫和手术入路方面,仍存在一些细节问题,成为当前争论的焦点。如淋巴清扫的内侧界,结肠肝曲癌常规清扫No.6淋巴结,手术入路除了经典的中间入路之外,头侧入路和尾侧入路是否更有优势,以及手术中的对Henle’s干解剖变异的认识等。Laparoscopic right hemicolectomy for right colon cancer is now technically mature.However,it remained some controversies in terms of lymph node dissection and surgical approach,including the definition of the medial border of D3 lymph node dissection,the necessity of No. 6 LN dissection for right colon cancer especially when tumor located in hepatic flexure,the anatomical variation of Henle＇s trunk,and the selection of different surgical approach for right colon cancer,such as medial approach,caudal approach and cranial approach,etc.

关 键 词：结肠肿瘤 腹腔镜检查 淋巴结切除术 

分 类 号：R735.35[医药卫生—肿瘤]