县级医院复制基于膜解剖的腹腔镜右半结肠癌根治术的初步经验(附28例报告)  

Preliminary experience of replicating laparoscopic radical resection of right colon cancer based on membrane anatomy in a county-level hospital:with a report of 28 cases

作　　者：胡大迁 苏刚 余蓉 肖坤[1] 覃吉超 张国飞[1] HU Da-qian;SU Gang;YU Rong(Department of Gastrointestinal Surgery,Gong'an County People's Hospital,Jingzhou 434300,China)

机构地区：[1]公安县人民医院胃肠外科,湖北荆州434300 [2]华中科技大学同济医学院附属同济医院普通外科

出　　处：《腹腔镜外科杂志》2022年第1期60-62,80,共4页Journal of Laparoscopic Surgery

基　　金：国家自然科学基金面上项目(82173368)。

摘　　要：目的:探讨县级医院复制基于膜解剖右半结肠癌根治性切除术的可行性及应用价值。方法:回顾分析28例腹腔镜右半结肠癌手术(基于膜解剖术式)患者的临床资料,记录手术时间、术中出血量、清扫淋巴结数量、术后并发症、术后恢复情况。结果:28例手术均获成功,手术时间135~246 min,平均(182.2±41.3)min;术中出血量10~45 mL,平均(18.5±9.3)mL;清扫淋巴结数量17~34枚,平均(25.7±4.5)枚;住院14~20 d,平均(16.3±3.6)d。术后发生乳糜瘘1例、吻合口出血1例、肺部感染1例,均经保守治疗后治愈;无手术死亡病例。结论:基于膜解剖的右半结肠癌根治术安全性高,肿瘤根治性好,可行性高,术者掌握良好的膜解剖理论、具有一定腹腔镜操作基础、具备高清或3D手术设备、团队配合默契完全可复制,适合在县级医院推广。Objective:To explore the feasibility of replicating laparoscopic radical resection of right colon cancer based on membrane anatomy in a county-level hospital and evaluate its application value.Methods:The clinical data of 28 patients who received laparoscopic right hemicolectomy based on membrane anatomy were retrospectively analyzed,including operation time,intraoperative bleeding,number of retrieved lymph nodes,postoperative complications and postoperative recovery.Results:All 28 patients successfully underwent laparoscopic right hemicolectomy based on membrane anatomy.The operative time was 135-246 min,with an average of(182.2±41.3)min.The intraoperative blood loss was 10-45 mL,with an average of(18.5±9.3)mL.The number of retrieved lymph nodes was 17-34,with an average of(25.7±4.5).The hospital stay was 14-20 d,with an average of(16.3±3.6)d.25 of 28 cases recovered favorably,the rest 3 cases had complications after surgery,1 case was complicated with chyle fistula,1 with anastomotic hemorrhage and 1 with pulmonary infection,which were all cured after conservative treatment,and there was no operative death.Conclusions:Laparoscopic radical resection of right colon cancer based on membrane anatomy associates with high safety,satisfactory radical resection and high feasibility.With proficient knowledge of membrane anatomy,certain foundation of laparocopic operation,high-definition or 3D laparoscopic equipment and tacit cooperation,this procedure can be repeatedly performed and is suitable to be popularized in the county-level hospitals.

关 键 词：结肠肿瘤 右半结肠癌根治术 腹腔镜检查 县级医院 膜解剖 

分 类 号：R735.35[医药卫生—肿瘤]