尾侧联合肠系膜上静脉优先入路机器人辅助下全结肠系膜切除治疗右半结肠癌的效果  

Application of"caudal to cranial"plus"superior mesenteric vein"technique with robotic-assisted complete mesocolic excision for right colon carcinoma

作　　者：连玉贵 周全博[1] 段小飞[1] 王贵宪[1] 袁维堂[1] LIAN Yugui;ZHOU Quanbo;DUAN Xiaofei;WANG Guixian;YUAN Weitang(Department of Colorectal Surgery,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院结直肠外科,郑州450052

出　　处：《郑州大学学报（医学版）》2021年第3期341-345,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金联合项目(U200410347)。

摘　　要：目的:探讨尾侧联合肠系膜上静脉优先入路机器人辅助下全结肠系膜切除治疗右半结肠癌的有效性和安全性。方法与结果:20例右半结肠癌患者,男12例,女8例,年龄31~78(中位数59)岁,均行尾侧联合肠系膜上静脉优先入路机器人辅助下全结肠系膜切除术。20例均顺利完成手术,手术时间135~240(中位数170)min,术中失血量30~200(中位数80)mL,淋巴结获取总数12~37枚,无中转开腹、围术期死亡及30 d内非计划再次入院。术后1例出现切口感染,换药后愈合;1例出现淋巴漏,采取禁食加全胃肠外营养支持加生长抑素治疗后痊愈;无Clavien-Dindo分级Ⅲ级以上并发症发生。住院时间6~19 d。结论:尾侧联合肠系膜上静脉优先入路机器人辅助下全结肠系膜切除治疗右半结肠癌安全、可行。Aim:To evaluate the efficacy and safety of application of"caudal to cranial"plus"superior mesenteric vein"technique with robotic-assisted complete mesocolic excision for right colon carcinoma.Methods and Results:The data of 20 right colon carcinoma patients undergoing"caudal to cranial"plus"superior mesenteric vein"technique with robotic assisted complete mesocolic excision for radical lymph node dissection were analyzed.The 20 patients(12 males and 8 females)aged 31-78(the median was 59)years.All the operation was successfully completed,and operative time was 135-240(the median was 170)min,operative blood loss was 30-200(the median was 80)mL,the total number of lymph nodes harvested was 12-37.There was no conversion,perioperative death and unplanned readmission within 30 days.One case had wound infection after operation and healed after dressing change;one case had lymphatic leakage and healed after fasting plus total parenteral nutrition plus somatostatin.No Clavien-DindoⅢor above complications occurred.Postoperative hospital stay was 6-19 days.Conclusion:"caudal to cranial"plus"superior mesenteric vein"technique with robotic assisted complete mesocolic excision for radical lymph node dissection in right hemicolectomy is safe and feasible.

关 键 词：右半结肠癌 全结肠系膜切除 机器人手术 手术入路 

分 类 号：R735.3[医药卫生—肿瘤]