腹腔镜“中间入路”全结肠系膜切除术治疗右半结肠癌(附76例报告)

Laparoscopic complete mesocolic excision in intermediate approach for right colon cancer:with a report of 76 cases

目的:探讨腹腔镜"中间入路"全结肠系膜切除术(complete mesocolic excision,CME)治疗右半结肠癌的疗效。方法:回顾分析2010年1月至2014年6月同一手术组为76例非转移结肠癌患者施行腹腔镜"中间入路"CME的临床资料。结果:76例手术均顺利完成,无一例中转开腹。术中清扫淋巴结平均(17.0±5.0)枚,手术时间平均(205.8±12.4)min,术中出血量平均(90.7±14.1)ml,肿瘤大小平均(5.5±1.9)cm,术后排气时间平均(6.0±3.0)d,平均住院(17.0±5.3)d。6例(7.89%)发生并发症,无死亡病例。结论:腹腔镜"中间入路"CME治疗右半结肠癌可达到肿瘤的根治性,术中出血少,术后康复快,未增加手术风险,术后短期随访疗效良好。

Objective：To explore the effect of laparoscopic complete mesocolic excision （CME） by intermediate approach in the treatment of right colon cancer. Methods： The clinical data of 76 patients who suffered from non-metastatic colon cancer and under- went laparoseopic CME in intermediate approach by the same group of surgeons between Jan. 2010 and Jun. 2014 at the first department of general surgery of the 4th People＇ s Hospital of Zigong were retrospectively analyzed. Results：All the 76 patients were operated suc- cessfully, without conversion to laparotomy. Intraoperative harvested lymph node was （ 17.0 ± 5.0 ） , the average time of operation was （205.8 ± 12.4） min,the average amount of bleeding during operation was （90.7 ± 14.1 ） ml,the mean tumor size was （5.5 ± 1.9） cm, the average postoperative exhaust time was （ 6.0 ± 3.0） d, the average hospital stay was （ 17.0 ± 5.3 ） d. The operation complica- tion rate was 7.89% （6/76） without death. Conclusions ：Laparoscopic CME in intermediate approach for right colon cancer has a radi- cal cure for tumor. It has the advantages of little bleeding, rapid recovery after operation, without increasing the risk of operation and so on. After operation, the curative effect is favorable during short-term follow up.