“翻页式”腹腔镜左半结肠切除术的安全性与可行性分析  

Safety and feasibility analysis of"page-turning"laparoscopic left hemicolectomy

作　　者：吕凯 袭祥鹏[2] 张永波[2] 郝大磊 王浩然 董龙展 王潇[2] 陈景波[2] LV Kai;XI Xiangpeng;ZHANG Yongbo(School of Clinical Medicine,Shandong Second Medical University,Weifang 261053,China;Department of General Surgery,the First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan Hospital,Key Laboratory of Metabolism and Gastrointestinal Tumor,Key Laboratory of Laparoscopic Technology)

机构地区：[1]山东第二医科大学临床医学院,山东潍坊261053 [2]山东第一医科大学第一附属医院、山东省千佛山医院普通外科、山东第一医科大学第一附属医院代谢与消化道肿瘤实验室、山东第一医科大学第一附属医院腹腔镜技术实验室

出　　处：《腹腔镜外科杂志》2024年第10期736-740,共5页Journal of Laparoscopic Surgery

摘　　要：目的:探讨“翻页式”腹腔镜左半结肠切除术的安全性与可行性。方法:回顾分析2023年1月至2023年11月施行“翻页式”腹腔镜左半结肠切除术的18例患者的临床资料,分析左半结肠游离时间、术中出血量、术后进食时间、术后住院时间、肿瘤大小、淋巴结清扫数量、术后并发症、术后病理分型、肿瘤分期等相关指标。结果:18例患者均顺利完成手术,无中转开腹,术中左半结肠游离时间平均(66.7±3.4)min,术中出血量10~100 mL,中位出血量50 mL。术后第1天均进流质饮食,术后住院8~12 d,中位数8 d。术后发生切口感染1例,肺炎2例,肺炎伴发热1例,下腹部切口愈合不良1例,均经保守治疗后康复,未出现吻合口出血、吻合口漏、围手术期死亡病例。术后病理结果均为腺癌,淋巴结清扫数量平均(21.0±1.5)枚,肿瘤最大直径3~17 cm,中位数5.25 cm,肿瘤分期Ⅱ_(A)期2例、Ⅱ_(B)期7例、Ⅲ_(B)期7例、Ⅲ_(C)期2例。结论:“翻页式”腹腔镜左半结肠切除术安全、可行,具有步骤清晰、操作简便、学习简单的特点,更利于初学者。Objective:To explore the safety and feasibility of"page-turning"laparoscopic left hemicolectomy.Methods:The clinical data of 18 patients who underwent"page-turning"laparoscopic left hemicolectomy from Jan.2023 to Nov.2023 were retrospectively analyzed,including the left hemicolon separation time,intraoperative blood loss,time of postoperative feeding,postoperative hospital stay,tumor size,number of lymph nodes harvested,postoperative complications,postoperative pathological typing,the stage of the tumor and other relevant indicators.Results:All the 18 operations were successfully completed without conversion to open surgery.The mean intraoperative separation time of left hemicolon was(66.7±3.4)min,and intraoperative blood loss ranged from 10 to 100 mL,with the median blood loss of 50 mL.All patients took liquid diet on the first day after operation.The postoperative hospital stay ranged from 8 to 12 d,with a median of 8 d.One patient had incision infection,two patients had pneumonia,one patient had pneumonia with fever,and one patient had poor healing of lower abdominal incision.All patients recovered after conservative treatment without anastomotic leakage or hemorrhage.There was no death during perioperative period.The pathological results of all patients were adenocarcinoma.The mean number of harvested lymph node was(21.0±1.5),and the maximum diameter of the tumor ranged from 3 to 17 cm,with the median of 5.25 cm.The tumor stages included stageⅡ_(A) in 2 patients,stageⅡ(B) in 7 patients,stageⅢ_(B) in 7 patients,and stageⅢ_(C) in 2 patients.Conclusions:"Page-turning"laparoscopic left hemicolectomy is safe and feasible with clear steps,easy to perform and learn,which is more favorable to beginners.

关 键 词：结肠肿瘤 左半结肠切除术 翻页式 腹腔镜检查 

分 类 号：R735.35[医药卫生—肿瘤]