腹腔镜辅助右半结肠癌根治术的临床应用

Clinical application of laparoscopic-assisted radical resection of the right colon cancer

目的:探讨腹腔镜辅助右半结肠癌根治术的方法及应用价值。方法:回顾分析2006年2月至2008年12月我院24例右半结肠癌患者的临床资料及手术方法。术中用超声刀切开右半结肠外侧腹膜,游离升结肠及右半横结肠,游离清除肠系膜上血管根部淋巴结,体外切除肿瘤,吻合肠管。结果:22例顺利完成腹腔镜手术,2例中转开腹。手术时间140～360min,平均202min,术中出血平均70ml,术后恢复肠蠕动平均32h,术后平均住院8d,术后2例切口感染,1例炎性肠梗阻,无出血、肠漏等严重并发症发生及死亡病例。结论:腹腔镜辅助右半结肠癌根治术安全有效,符合微创手术切口小、患者痛苦轻、康复快的优点及肿瘤根治原则。

Objective：To investigate the method and application value of laparoscopic-assisted radical resection of right colon cancer. Methods：The clinical data and surgical methods of 24 cases right colon cancer from Feb. 2006 to Dee. 2008 in our hospital were retrospectively analyzed. In the operations of these cases, the lateral peritoneum of right colon was dissected by ultrasonic scalpel, ascending colon and the right transverse colon was dissociated, the lymph nodes in root of superior mesenteric vessels were removed, tumor was resected and intestinal anastomosis was performed in vitro. Results ： Twenty-two laparoscopic operations were successfully completed,two cases were converted to open surgery. The average operative time was 202rain （range 140-360） , average blood loss was 70ml, the average resumption time of bowel movement was 32h, and the average hospital stay was 8d. In addition to 2 cases of wound in- fection, 1 case of inflammatory intestinal obstruction, no severe complications were found, such as bleeding,intestinal leakage or death. Conclusions ： Laparoscopic-assisted radical resection of right colon cancer is safe and effective, in line with the radical principle and advantages of minimally invasive surgery, such as small incision,light pain and quick recovery.