腹腔镜右半结肠切除18例临床分析

The clinical analysis of 18 cases of laparoscopic right hemicolectomy

目的：探讨腹腔镜右半结肠切除治疗结肠肿瘤的安全性与可行性。方法回顾性分析我院普外科自2008年9月~2013年10月腹腔镜右半结肠切除术18例临床资料，总结其手术安全性、术后恢复情况及近期肿瘤治疗效果。结果全组无严重并发症和死亡病例，2例（11.1%）中转开腹，平均手术时间（163.6±12.2）min，手术出血（26.7±23.0）ml，辅助切口长（5.4±0.6）cm，术后排气时间（2.5±0.7）d，住院时间（7.7±1.1）d，淋巴结清扫数目（17.9±3.4）枚。随访时间平均为23（5~61）月，1例出现肝转移，无戳孔和局部复发。结论腹腔镜右半结肠切除术治疗结肠肿瘤安全有效，其远期疗效有待更多随机对照研究证实。

Objective To explore the safety and feasibility of laparoscopic right hemicolectomy （LRH） for colon tumor. Methods A retrospective study of eighteen patients with right colon tumor who underwent LRH in our hospital from Sep 2008 to Oct 2013 was performed. The safety of operation, status of recovery, oncological results of short term follow-up were studied. Results Full set had no serious complications and deaths. Two cases （11.1%） were converted to accept open surgery. The aver-age operative time was （163.6±12.2）min. The blood loss was （26.7±23.0）ml. The average incision length was （5.4±0.6）cm. The average time for passage of flatus and hospitalization was （2.5±0.7）d,（7.7±1.1）d respectively. The number of dissected lymph nodes was 17.9±3.4. The average follow-up time was 23（5~61） months and there was 1 case of liver metastases（5.3%） dur-ing follow-up, but no port-site or local recurrence occured. Conclusion LRH is a technically safe and effective procedure for treating right colon tumor. More prospective randomized controlled trials are necessary to demonstrate the long-term follow-up results.