腹腔镜右半结肠切除术35例临床分析

目的:探讨腹腔镜右半结肠切除术治疗结肠癌的安全性与有效性。方法:回顾分析2002年2月至2004年12月行腹腔镜辅助右半结肠切除术35例患者的临床资料和随访情况,以研究其手术的安全性,术后康复情况及肿瘤的根治性效果。结果:术中未发生严重并发症和死亡病例,2例(5.7%)中转开腹,手术时间(155.14±35.79)min,术中出血(111.43±87.62)ml,辅助切口长(5.69±1.00)cm,患者排气时间(2.54±1.12)d,总住院时间(14.54±6.45)d。清扫淋巴结总数14(0~50)枚,其中结肠上、旁淋巴结4(0~21)枚,系膜间淋巴结5(0~18)枚,血管根部淋巴结3(0~35)枚,手术切除标本长度(20.73±7.14)cm,肺部感染、术后腹水、腹腔局部积液、乳糜漏各1例,余者未见术后并发症,患者均获随访,平均41个月(8~68个月),2例局部复发,3例术后发生肝转移,累计生存率为76.8%。结论:腹腔镜右半结肠切除术治疗右半结肠癌安全有效,符合肿瘤根治原则。

The clinical analysis of laparoscopic-assisted right hemicolectomy:a report of 35 cases

Objective:To explore the feasibility and safety of laparoscopic-assisted right hemicolectomy for colonic carcinoma.Methods:The safety of operation,status of recovery,complication,oncological clearance and results of short term follow-up were studied in 35 patients underwent laparoscopic-assisted right hemicolectomy for colonic cancer between Feb.2002 and Dec.2004.Results:Two cases(5.7%)were converted to open surgery.The average operative time was(155.14±35.79)min and the blood loss was(111.43±87.62)ml.The average incision length was(5.69±1.00)cm.The average time for passage of flatus and hospitalization were(2.54±1.12)d,(14.54±6.45)d respectively.The total number of lymph nodes removed was 14(0～50),and the average length of specimen removed was(20.73±7.14)cm.Complilations were observed in 4 of 35 patients,that were pulmonary infection,abdominal part fluidify,abdominal dropsy and chylus leak.The average follow-up time was 41 months(8-68months).The cumulative survival rate at 41 months was 76.8%.Conclusions:Laparoscopic-assisted right hemicolectomy can be successfully performed for right colon carcinoma with all the advantages of minimally invasive surgery.