腹腔镜改良扩大右半结肠癌根治术35例病例分析  

Analysis of 35 cases of laparoscopic modified extended radical right hemicolectomy

作　　者：李帅鹏 杨成城 梁鸿 范青文 姚富强 杨展鹏 张超[1] LI Shuaipeng;YANG Chengcheng;LIANG Hong(Department of Gastrointestinal Surgery,Henan University People's Hospital,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南大学人民医院,河南省人民医院胃肠外科,河南郑州450003

出　　处：《腹腔镜外科杂志》2025年第1期34-37,42,共5页Journal of Laparoscopic Surgery

基　　金：2023年度河南省医学科技攻关计划项目(LHGJ20230003)。

摘　　要：目的:探讨腹腔镜改良扩大右半结肠癌根治术的安全性与可行性。方法:回顾分析2021年1月至2023年1月收治的35例结肠肝曲癌患者的临床资料。记录并分析患者围术期情况、并发症及术后病理。结果:手术时间平均(171.4±10.5)min,术中出血量平均(81.7±15.6)mL;1例患者因腹腔粘连严重中转开腹,1例患者联合行肝脏切除术,5例患者术中输血;术后发生1例吻合口漏、1例肠梗阻、2例切口感染,均经保守治疗后痊愈出院;中位术后首次肛门排气时间4(3,5)d,中位术后恢复流质饮食时间5(4,6)d;中位淋巴结获取数量为32(18,50)枚,中位阳性淋巴结获取数量为0(0,1)枚,No.206组淋巴结获取数量为63枚,阳性No.206组淋巴结获取数量为1枚,No.223组淋巴结获取数量为102枚,阳性No.223组淋巴结获取数量为2枚。结论:腹腔镜改良扩大右半结肠癌根治术安全、可行。Objective:To explore the safety and feasibility of laparoscopic modified extended radical right hemicolectomy.Methods:Clinical data of 35 patients with hepatic flexure colon carcinoma admitted from Jan.2021 to Jan.2023 were retrospectively analyzed.Preoperative,intraoperative,and postoperative conditions,particularly complications and pathological outcomes,were recorded and analyzed.Results:The average operative time was(171.4±10.5)min,and the mean intraoperative blood loss was(81.7±15.6)mL.One patient required conversion to open surgery due to severe abdominal adhesions,one patient was combined with hepatectomy,and 5 patients received the intraoperative blood transfusion.No cases of postoperative gastroparesis occurred,1 patient had postoperative anastomotic leakage,1 patient had postoperative intestinal obstruction,2 patients had postoperative incision infection,all of them recovered and were discharged after conservative treatment.The median postoperative time to first flatus was 4(3,5)d,the median postoperative time to resumption of a liquid diet was 5(4,6)d,the median number of lymph nodes harvested was 32(18,50),the median number of positive lymph nodes harvested was 0(0,1),the number of No.206 group lymph nodes harvested was 63,and the number of positive No.206 group lymph nodes harvested was 1,the number of lymph nodes harvested in the No.223 group was 102,and the number of p ositive lymph nodes harvested in the No.223 group was 2.Conclusions:Laparoscopic modified extended radical right hemicolectomy is safe and feasible.

关 键 词：结肠肿瘤 改良扩大右半结肠癌根治术 腹腔镜检查 

分 类 号：R735.35[医药卫生—肿瘤]