中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
Chinese Journal of Gastrointestinal Surgery
2015年
11期
1124-1127
,共4页
邹瞭南%熊文俊%李洪明%何耀彬%刁德昌%郑燕生%罗立杰%谭萍%王伟
鄒瞭南%熊文俊%李洪明%何耀彬%刁德昌%鄭燕生%囉立傑%譚萍%王偉
추료남%웅문준%리홍명%하요빈%조덕창%정연생%라립걸%담평%왕위
结肠肿瘤,右半结肠%腹腔镜手术%尾侧入路%临床疗效
結腸腫瘤,右半結腸%腹腔鏡手術%尾側入路%臨床療效
결장종류,우반결장%복강경수술%미측입로%림상료효
Colon neoplasms,right side colon%Laparoscopic surgery%Caudal-to-cranial approach%Clinical efficacy
目的 探讨尾侧入路法(即以肠系膜根部右髂窝附着处与后腹膜愈着的"黄白交界线"为手术入路)实施腹腔镜右半结肠癌根治性切除术的安全性和可行性.方法 回顾性分析2014年1月至2015年5月广东省中医院胃肠外科连续收治的行尾侧入路法腹腔镜右半结肠癌根治性切除术的76例患者的临床资料.结果 全组76例患者均顺利完成手术,其中1例(1.3%)患者因术中损伤回结肠动脉出血而中转开腹手术.手术时间为(152.8±42.1) min,术中失血量为(70.4±43.5) ml;术后首次排气时间为(49.3±22.9)h,恢复流质饮食时间为(58.5±17.6)h.术后出现并发症者7例(9.2%),其中肺部感染、泌尿系感染、淋巴管瘘各1例,切口感染及炎性肠梗阻各2例,均经保守治疗后痊愈,无术中及术后死亡病例.术后住院时间为(7.8±5.4)d.术后病理结果示:肿瘤直径(4.5±3.2)cm,淋巴结清扫数目(34.2±10.9)枚,其中阳性淋巴结数目(4.1±2.8)枚;肿瘤分期:Ⅰ期8例,ⅡA期14例,ⅡB期22例,ⅡC期2例,ⅢA期15例,ⅢB期12例,ⅢC期3例.结论 尾侧入路法腹腔镜右半结肠癌根治性切除术是安全、可行的.
目的 探討尾側入路法(即以腸繫膜根部右髂窩附著處與後腹膜愈著的"黃白交界線"為手術入路)實施腹腔鏡右半結腸癌根治性切除術的安全性和可行性.方法 迴顧性分析2014年1月至2015年5月廣東省中醫院胃腸外科連續收治的行尾側入路法腹腔鏡右半結腸癌根治性切除術的76例患者的臨床資料.結果 全組76例患者均順利完成手術,其中1例(1.3%)患者因術中損傷迴結腸動脈齣血而中轉開腹手術.手術時間為(152.8±42.1) min,術中失血量為(70.4±43.5) ml;術後首次排氣時間為(49.3±22.9)h,恢複流質飲食時間為(58.5±17.6)h.術後齣現併髮癥者7例(9.2%),其中肺部感染、泌尿繫感染、淋巴管瘺各1例,切口感染及炎性腸梗阻各2例,均經保守治療後痊愈,無術中及術後死亡病例.術後住院時間為(7.8±5.4)d.術後病理結果示:腫瘤直徑(4.5±3.2)cm,淋巴結清掃數目(34.2±10.9)枚,其中暘性淋巴結數目(4.1±2.8)枚;腫瘤分期:Ⅰ期8例,ⅡA期14例,ⅡB期22例,ⅡC期2例,ⅢA期15例,ⅢB期12例,ⅢC期3例.結論 尾側入路法腹腔鏡右半結腸癌根治性切除術是安全、可行的.
목적 탐토미측입로법(즉이장계막근부우가와부착처여후복막유착적"황백교계선"위수술입로)실시복강경우반결장암근치성절제술적안전성화가행성.방법 회고성분석2014년1월지2015년5월광동성중의원위장외과련속수치적행미측입로법복강경우반결장암근치성절제술적76례환자적림상자료.결과 전조76례환자균순리완성수술,기중1례(1.3%)환자인술중손상회결장동맥출혈이중전개복수술.수술시간위(152.8±42.1) min,술중실혈량위(70.4±43.5) ml;술후수차배기시간위(49.3±22.9)h,회복류질음식시간위(58.5±17.6)h.술후출현병발증자7례(9.2%),기중폐부감염、비뇨계감염、림파관루각1례,절구감염급염성장경조각2례,균경보수치료후전유,무술중급술후사망병례.술후주원시간위(7.8±5.4)d.술후병리결과시:종류직경(4.5±3.2)cm,림파결청소수목(34.2±10.9)매,기중양성림파결수목(4.1±2.8)매;종류분기:Ⅰ기8례,ⅡA기14례,ⅡB기22례,ⅡC기2례,ⅢA기15례,ⅢB기12례,ⅢC기3례.결론 미측입로법복강경우반결장암근치성절제술시안전、가행적.
Objective To investigate the safety and feasibility of laparoscopic radical right hemicolectomy using caudal-to-cranial approach (yellow-white borderline between right mesostenium and retroperitoneal is firstly cut as the entry to dissect the fusion fascial space between the visceral and parietal peritoneum, which is called caudal-to-cranial approach for right hemicolectomy).Methods From January 2014 to May 2015, 76 consecutive patients with right side colon cancer underwent laparoscopic radical right hemicolectomy using caudal-to-cranial approach.The baseline characteristics, intraoperative and postoperative outcomes wcre prospective collected and reviewed retrospectively.Results All the 76 patients completed operations successfully, and one patient (1.3%)was converted to open surgery because of intraoperative bleeding due to unexpected injury of ileocolic artery.The mean operative time was (152.8±42.1) min with a mean estimated blood loss of (70.4±43.5) rnl.The mean time of first flatus was (49.3±22.9) h and mean liquid oral intake was (58.5±17.6) h.The postoperative complications appeared in 7 patients (9.2%), including one (1.3%) of pulmonary infection, one (1.3%) of urinary system infection, two (2.6%) of wound infection, two (2.6%) of inflammatory bowel obstruction and one (1.3%) of lymphatic fistula, and they were all cured with conservative treatments.The postoperative hospital stay was (7.8±5.4) d.The mean number of harvested lymph node was 34.2±10.9, among which 4.1±2.8 was positive.Conclusions Laparoscopic radical right hemicolectomy using caudal-to-cranial approach is safe and feasible.