腹腔镜辅助右半结肠癌根治术57例临床分析

目的探讨腹腔镜辅助右半结肠癌切除的手术方法和疗效。方法回顾性分析57例行腹腔镜辅助右半结肠癌切除手术患者的临床资料。结果51例顺利完成腹腔镜辅助右半结肠癌根治术,3例中转开腹（其中1例因肿瘤侵犯十二指肠,2例回盲部肿瘤〉8 cm）,3例因广泛转移仅行开关腹手术,无手术死亡。平均手术时间160（130-250）min,平均出血量110（50-150）ml,平均术后住院天数9.6（7-13）d。1例术后2 d发现肺部感染,1例术后第5 d出现不完全性肠梗阻,经对症处理后好转。57例随访6-36月,其中2例腹腔镜手术患者发生双肺部转移而死亡,1例开腹手术患者发生肝转移,1例发现Trocar穿刺处肿瘤种植并腹腔内远处转移,后2例患者放弃治疗。结论只要严格掌握手术适应证,熟练应用腹腔镜技术,腹腔镜辅助右半结肠癌切除是安全可行的。

Laparoscopic-assisted Right Hemicolectomy of Colon Carcinoma (Analysis of 57 Cases)

Objective To explore the modified surgical technique and indication of laparoscopic-assisted right hemicolectomy for colon carcinoma. Method A retrospective analysis was taken of the clinical data of 57 patients underwent laparoscopic-assisted right hemicolectomy for colon carcinoma between October 2003 and March 2008. Results 51 cases of laparoscopic-assisted resection were successfully performed. Three cases were conversed to open surgery because of the duodenum involvement in 1 patient, and the diameter of ileocecal tumor 〉 8cm in 2 patients. No patient died during operation. The mean operation time was 160（ 130 -250）mi- nutes, the mean blood loss volume was 110（ 50 - 150 ） ml, the mean time of postoperative hospitalization was 9.6（7 - 13 ） days. One patient suffered from pulmonary infection and 1 patient occurred incomplete intestinal obstruction, which were all cured by symptomatic treatment. All the cases were followed up for 6 to 36 months. 53 cases survived without recurrence or metastasis. Conclusion It is safe and feasible of the laparoscopic-assisted right hemicolectomy for colon carcinoma.