中间入路法腹腔镜辅助结肠癌根治术50例临床分析

Laparoscopy-assisted radical resection of colon cancer with a medial-to-lateral-approach:with a report of 50 cases

目的:总结中间入路法腹腔镜辅助结肠癌根治术的手术经验及应用价值。方法:回顾分析2008年1月至2010年6月利用中间入路法行50例腹腔镜辅助结肠癌根治术的临床资料及短期随访结果。结果:手术时间平均(165±35)min,术中出血量平均(140±61)ml,平均清扫淋巴结(13.0±3.7)枚,17例区域淋巴结阳性,平均切除肠管(18.2±8.0)cm。术后随访12～36个月,肿瘤相关死亡1例,1例局部复发。无切口种植、吻合口出血、吻合口漏等并发症发生。结论:中间入路法腹腔镜辅助结肠癌根治术路径明确,解剖层面清晰,易掌握。中间入路法先结扎肿瘤血管,符合肿瘤根治原则,是腹腔镜辅助结肠癌根治手术的最佳路径。

Objective： To summarize the operative experience and application value of laparoscopy-assisted radical resection of colon cancer with a medial-to-lateral-approach. Methods：The clinical data and the short term follow-up results of 50 patients who underwent laparoscopy-assisted colectomy with a medial-to-lateral approach during Jan.2008 and Jun.2010 were analyzed retrospectively. Results：The operative time was（165±35） min.The blood loss was（140±61） ml.The number of harvested lymph nodes was（13.0±3.7）,and regional lymph node with cancer cells was found in 17 cases.The mean length of resected intestine was（18.2±8.0） cm.After 12-36 months of follow-up,cancer-related death and local recurrence occurred in 1 patient respectively.No incision planting,anastomotic hemorrhage,anastomotic leakage or such kinds of complications were found. Conclusions：The laparoscopy-assisted radical resection of colon cancer with a medial-to-lateral approach has the advantages of definite paths,clear anatomical compartments and easy control.Ligation of tumor blood vessels first,meeting cancer radical operation principle,medlial-to-lateral approach is the best surgery approach for laparoscopic-assisted radical resection of colon cancer.