腹腔镜左半结肠切除38例临床分析

The clinical analysis of laparoscopic left hemicolectomy:a report of 38 cases

目的：探讨腹腔镜左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2007年7月至2013年12月腹腔镜左半结肠切除术治疗38例结肠癌患者的临床资料,研究其手术安全性、术后恢复情况及肿瘤根治性效果。结果：全组无严重并发症和死亡病例,2例（5.3%）中转开腹,手术时间（134.5±19.5）分钟,术中出血（22.2±10.2）ml,辅助切口长（5.5±0.7）cm,术后排气时间（2.5±0.7）天,住院时间（7.5±1.2）天,淋巴结清扫数目（18.7±4.6）枚。随访平均24（2-62）个月,2例出现远处转移,但无戳孔或切口以及局部复发。结论：腹腔镜左半结肠切除术治疗结肠癌安全有效,其结果有待多中心的随机对照研究证实。

Objective To explore the feasibility and safety of laparoscopic left hemicolectomy（ LLH） for descending colon cancer. Method A retrospective study of thirty-eight patients with descending colon cancer, who underwent a LLH between July 2007 and December 2013 was performed. The safety of operation, status of recovery, complica-tion, oncological clearance and results of short term follow-up were studied. Result Two cases（5. 3%） were conver-ted to open surgery. The average operative time was （134. 5±19. 5）min. The blood loss was （22. 2±10. 2）ml. The average incision length was（ 5. 5±0. 7）cm. The average time for passage of flatus and hospitalization were（2. 5±0. 7）d,（ 7. 5±1. 2）d respectively. The number of dissected lymph nodes was （18. 7±4. 6）. The average follow-up time was 24（2-62） months and there were 2 distant metastases（5. 3%） during follow-up, but no port-site or local recurrence. Conclusion Laparoscopic left hemicolectomy is a technically safe and feasible procedure for treationg descending colon cancer. Prospective multi-center trials are necessary to establish the LLH as the standard treatment for descending colon cancer.