以肠系膜动脉左侧为清扫内侧界的腹腔镜全结肠系膜切除术治疗右半结肠癌的临床效果  

Clinical Effect of Laparoscopic Complete Mesorectal Excision with Left Mesenteric Artery as the Dissection Medial Boundary in the Treatment of Right Colon Cancer

作　　者：秦蒙华 李建锋[1] QIN Menghua;LI Jianfeng(Department of General Surgery,Zhengzhou Seventh People's Hospital,Zhengzhou 450016,China)

机构地区：[1]郑州市第七人民医院普外科,河南郑州450016

出　　处：《临床医学工程》2023年第7期895-896,共2页Clinical Medicine & Engineering

摘　　要：目的探讨以肠系膜动脉左侧为清扫内侧界的腹腔镜全结肠系膜切除术(CME)治疗右半结肠癌患者的临床效果。方法89例右半结肠癌患者均经尾侧-中间入路实施腹腔镜CME治疗,根据淋巴结清扫内侧界不同分为研究组(45例,以肠系膜动脉左侧作为清扫内侧界)和参照组(44例,以肠系膜静脉左侧作为清扫内侧界)。比较两组的手术情况、术后恢复情况及并发症。结果研究组淋巴结清扫数、淋巴结阳性数高于参照组(P<0.05)。研究组术后引流量高于参照组,术后引流时间长于参照组(P<0.05)。两组的并发症发生率(17.78%vs.11.36%)比较,差异无统计学意义(P>0.05)。结论以肠系膜动脉左侧为清扫内侧界的腹腔镜CME治疗右半结肠癌能够增强淋巴结清扫效果,具有较高的安全性,但会加重炎性反应,影响局部血液循环,一定程度上不利于患者术后恢复。Objective To explore the clinical effect of laparoscopic complete mesocolic excision(CME)with left mesenteric artery as the dissection medial boundary in the treatment of patients with right colon cancer.Methods 89 patients with right colon cancer were treated with laparoscopic CME via caudal-intermediate approach.According to the different dissection medial boundary of lymph node,they were divided into study group(45 cases,left mesenteric artery as the dissection medial boundary)and the control group(44 cases,left mesenteric vein as the dissection medial boundary).The operation state,postoperative recovery and complications were compared between the two.groups.Results The numbers of lymph node clearance and positive lymph nodes in the study group were higher than those in the control group(P<0.05).The postoperative drainage of the study group was more than that of the control group,and the postoperative drainage time was longer than that of the control group(P<0.05).No statistical difference was found in the incidence of complications(17.78%vs.11.36%)between the two groups(P>0.05).Conclusions Laparoscopic CME with left mesenteric artery as the dissection medial boundary in the treatment of right colon cancer can enhance the effect of lymph node dissection with higher safety,but it will aggravate the inflammatory reaction and affect the local blood circulation,which is not conducive to postoperative recovery of patients to a certain extent.

关 键 词：右半结肠癌 肠系膜动脉 腹腔镜全结肠系膜切除术 并发症 

分 类 号：R735.35[医药卫生—肿瘤]