腹部无辅助切口经阴道拖出标本的完全腹腔镜右半结肠癌根治术的近期疗效(附14例报告)  

Short-term outcomes of totally laparoscopic right hemicolectomy with transvaginal specimen extraction: with a report of 14 cases

作　　者：卢召 周海涛 梁建伟 关旭 张明光 刘正 姜争 刘骞 郑朝旭 王锡山 LU Zhao;ZHOU Hai-tao;LIANG Jian-wei(Department of Colorectal Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心,中国医学科学院北京协和医学院肿瘤医院,北京100021

出　　处：《腹腔镜外科杂志》2018年第11期823-826,共4页Journal of Laparoscopic Surgery

基　　金：国家重点研发计划精准医学研究专项(编号:2016YFC0905300);国家重点研发计划(编号:2017YFC0908203);北京市科技计划(编号:D171100002617004);中国医学科学院医学与健康科技创新工程项目(编号:2016-I2M-1-001,编号:2017-I2M-2-003)

摘　　要：目的:探讨腹部无辅助切口经阴道拖出标本的完全腹腔镜右半结肠癌根治术的可行性、安全性及近期疗效。方法:收集2015年10月至2018年8月行腹部无辅助切口经阴道拖出标本的完全腹腔镜右半结肠癌根治术14例患者的临床资料,分析患者的临床病理特征、手术情况及对术后患者恢复情况、围术期并发症发生率等近期疗效的影响。结果:14例患者均顺利完成手术,无一例中转开腹。14例均为女性,中位年龄54.5岁,中位手术时间217.5 min,中位术中出血量50 m L,中位切除小肠长度为14 cm,中位切除结肠长度为27.5 cm,中位清扫淋巴结数量37.5枚,中位术后排气时间、排便时间、进食时间、住院时间分别为3 d、4 d、4 d、6.5 d。术后均无吻合口出血、吻合口漏、吻合口狭窄、阴道出血、直肠阴道瘘等严重并发症发生。结论:选择合适的右半结肠癌女性患者,采用腹部无辅助切口经阴道拖出标本的完全腹腔镜右半结肠癌根治术是安全、可行的,近期疗效满意。Objective:To analyze the feasibility,safety and short-term outcomes of totally laparoscopic right hemicolectomy with transvaginal specimen extraction.Methods:From Oct.2015 to Aug.2018,14 patients with right colon cancer underwent totally laparoscopic right hemicolectomy with transvaginal specimen extraction.The clinical pathologic data of these patients were retrospectively collected and analyzed to assess the impact of the operation on postoperative recovery and the incidence of perioperative complications.Results:All operations were successfully accomplished without conversion to open surgery or conventional laparoscopic-assisted surgery.14 patients were all female with a median age of 54.5 years old.The median operative time was 217.5 min.The median blood loss was 50 mL.The median length of resected small intestine and colon were 14cm and 27.5cm respectively.The median number of lymph nodes harvested was 37.5.The median time to first flatus,time to first defecation,time to start diet and postoperative hospital stay were 3d,4d,4d and 6.5d,respectively.No patient suffered from anastomotic bleeding,leakage,stenosis,vaginal bleeding or rectovaginal fistula.Conclusions:Totally laparoscopic right hemicolectomy with transvaginal specimen extraction appears to be feasible,safe and can achieve promising short-term outcomes for selected female patients with right colon cancer.

关 键 词：结肠肿瘤 腹腔镜检查 经自然腔道取标本手术 经阴道 

分 类 号：R735.35[医药卫生—肿瘤]