网膜融合线导向的脾曲游离技术在左半结肠癌根治术中的应用  

Omental fusion line-guided splenic flexure mobilization technique in radical left hemicolon for colon cancer

作　　者：任佳琪 刁德昌[2] 何自衍 张雪阳 唐新 李文娟[1] 李洪明[3] 卢新泉 易小江 Ren Jiaqi;Diao Dechang;He Ziyan;Zhang Xueyang;Tang Xin;Li Wenjuan;Li Hongming;Lu Xinquan;Yi Xiaojiang(The Second Clinical Medical School,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Department of Gastrointestinal Surgery,Sixth Hospital,Sun Yat-Sen Univeristy,Guangzhou 510655,China;Department of Gastrointestinal Surgery,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二临床医学院,510405 [2]中山大学附属第六医院胃肠外科,广州510655 [3]广东省中医院胃肠外科,广州510120

出　　处：《中华结直肠疾病电子杂志》2024年第5期362-367,共6页Chinese Journal of Colorectal Diseases(Electronic Edition)

摘　　要：目的本研究旨在探讨以膜解剖为基础的网膜融合线导向脾曲游离技术应用于左半结肠癌根治术的安全性及有效性。方法采用观察性研究的方法,回顾性收集2018年1月至2023年12月于广东省中医院胃肠肿瘤中心行腹腔镜下左半结肠根治性切除术共112例患者的临床资料,包括患者基础资料、术前检查、手术视频及术后一般情况等。并观察患者腹腔镜下操作时间、术中出血量、脾曲游离时间、脾曲游离出血量、术后并发症、术后住院时间等指标。结果所有患者均顺利完成手术,无中转开腹,无相关脾脏、胰腺及胃网膜血管损伤。其中,中位腹腔镜下操作时间42.0(36.0,46.8)min,中位脾曲游离时间14.0(12.0,16.0)min,中位术中出血量50(20.0,50.0)mL,中位脾曲游离出血量3.0(1.1,7.0)mL。中位术后住院时间6.0(5.0,7.0)天,术后无出血、胰瘘、肠瘘等相关并发症。结论网膜融合线导向的脾曲游离技术应用于腹腔镜下左半结肠癌根治术安全可行,能有效解决结肠脾曲游离的技术难点,可进一步推广应用。Objective The purpose of this study is to explore the feasibility and safety of the omental fusion line-guided splenic flexure mobilization(SFM)technique based on fascia anatomy in radical surgery for left-sided colon cancer.Methods Using the method of observational study,our study retrospectively collected the clinical data of 112 patients who underwent laparoscopic radical resection for left-sided colon cancer at the Department of Gastrointestinal Surgery of Guangdong Province Hospital of Traditional Chinese Medicine from January 2018 to December 2023.The data included some basic information,preoperative examinations,surgical videos,and general postoperative conditions.The study observed indicators including laparoscopic operating time,intraoperative blood loss,splenic flexure mobilization time,splenic flexure blood loss,postoperative complications,and postoperative hospital stay.Results All patients successfully completed the surgery without conversion to open laparotomy.No complications related to splenic,pancreatic,or gastric omental vascular injuries occurred.Among them,the key outcomes included a median laparoscopic operating time of 42.0(36.0,46.8)minutes,a median splenic flexure mobilization time of 14.0(12.0,16.0)minutes,a median intraoperative blood loss of 50(20.0,50.0)mL,and median splenic flexure blood loss was 3.0(1.1,7.0)mL.The median postoperative hospital stay was 6.0(5.0,7.0)days,with no postoperative complications such as bleeding,pancreatic fistula,or intestinal fistula.Conclusion The omental fusion line-guided splenic flexure mobilization technique is safe and feasible to be applied in laparoscopic radical surgery for left-sided colon cancer,which can effectively addressing the technical challenges of splenic flexure mobilization of the colon,and can be further promoted and applied.

关 键 词：结直肠肿瘤 网膜融合线 左半结肠切除术 脾曲游离 

分 类 号：R735.35[医药卫生—肿瘤]