尾背侧入路在腹腔镜右半结肠癌根治术中的临床应用  

Clinical application of caudal-to-dorsal approach in laparoscopic right radical colon cancer resection

作　　者：曾海敬[1] 吴祖光[1] 李恩[1] ZENG Haijing;WU Zuguang;LI En(Department of Gastrointestinal Surgery,Meizhou People′ s Hospital,Meizhou,Guangdong 514031,China)

机构地区：[1]梅州市人民医院胃肠外科,广东梅州514031

出　　处：《岭南现代临床外科》2017年第5期539-542,共4页Lingnan Modern Clinics in Surgery

基　　金：广东省梅州科技计划项目科研课题(2016B038)

摘　　要：目的探讨经尾侧入路腹腔镜右半结肠切除术的安全性和可行性。方法回顾分析2016年1月至2016年12月,我科收治的需进行腹腔镜右半结肠癌根治切除术患者22例。按照采用尾背侧中间入路10例(简称尾背侧组)和尾腹侧中间入路12例(简称尾腹侧组);两组患者均进行腹腔镜右半结肠切除术,对两组患者的手术时间、手术出血量、淋巴结清扫个数、切除的标本质量、术后首次排气时间及吻合口瘘发生情况进行记录,同时比较结果。结果尾背侧组手术时间178.6±16.2 min、术中出血83.2±8.4 mL与尾腹侧组205.0±20.0 min、100.7±13.3 mL比较,差异具有统计学意义(P<0.05)。尾背侧组清扫淋巴结数目15.7±1.9枚,术后排气时间2.8±0.5 d、切除标本中系膜保留完整10例、无吻合口瘘,无中转开腹、住院日12.6±1.2 d;尾腹侧组16.3±1.7枚、2.8±0.5 d、12例、0例、0%、平均住院日12.7±1.1 d比较,差异无统计学意义(P>0.05)。手术标本系膜完整两组均完整无破损,尾背侧组与尾腹侧组各出现术后并发症1例(淋巴瘘),均于术后第4天出现,保守治疗3天后治愈。结论选择尾背侧入路在腹腔镜右半结肠癌根治切除术是安全的,可行的。Objective To investigate the safety and feasibility of laparoscopic right hemi colectomy through caudal?to?dorsal access.Methods From January2016to December2016,22patients with right colon cancer who were treated in our department were analyzed retrospectively.In accordance with the middle caudal?to?dorsal access or intermediate approach during radical resection of colon,10cases referred to as the caudal?to?dorsal group,and12cases performed by caudal?to?ventral approach were referred to as the tail?to ventral group.The operation time,blood loss,number of lymph node dissection and quality of surgical specimen,time of flatus and stoma fistula were recorded at the same time and the results were compared between two groups.Results The operation time of the caudal?to?dorsal group was178.6±16.2min,the intraoperative bleeding was83.2±8.4mL,and when compared with caudal?to?ventral group,the differences were statistically significant(205.0±20.0min and100.7±13.3mL,all P values<0.05).Conclusion Using Caudal?todorsalaccess is safe and feasible for laparoscopic radicalresection of the right colon cancer.

关 键 词：结肠肿瘤 右半结肠 腹腔镜手术 尾背侧入路 

分 类 号：R56.9[医药卫生—呼吸系统] R735.35[医药卫生—内科学]