腹腔镜右半结肠癌根治术的难点和技巧

Difficulty and skill of laparoscopic right colectomy

随着右半结肠癌发病率的升高，右半结肠癌根治手术的比例也越来越高。虽然腹腔镜的微创优势已经获得广泛的认同，但也部分增加了手术操作的难度。笔者通过本文分享腹腔镜右半结肠癌根治术的经验，包括如何正确进入Toldt间隙、回结肠血管和中结肠血管的处理以及 D3淋巴结清扫所遇到的问题，探讨手术中的几个难点及其处理技巧，望对初学者有所裨益。

With increace in the incidence of right colon cancer, the proportion of laparoscopic right colon resection is increasing. Though the advantage of laparoscopy in minimal invasiveness has been widely accepted, its procedure still possesses certain difficulty. In this article, we shared the experience of laparoscopic right colectomy, including entering the correct Toldt′s place, management of ileocolic and middle colic vessels and the problems of D3 lymph node dissection . Basic surgical techniques and several difficulties are discussed here, which may be helpful for beginners.