应用腔内三角吻合技术行完全腹腔镜左半结肠切除术的近期疗效

The short-term effect analysis of intracorporeal delta-shaped anastomosis in total laparoscopic left hemicolectomy

目的探讨应用腔内三角吻合技术在完全腹腔镜左半结肠切除术中的安全性及可行性。方法收集2017年1月1日至2017年10月1日间，采用腔内三角吻合技术行完全腹腔镜左半结肠切除术的11例患者的临床资料，回顾性分析患者的临床特征、手术情况、术后情况和围手术期并发症情况。结果11例患者的中位手术时间为121．8min，中位吻合时间为14．9min．中位术中出血量为45．5ml，中位近端切缘长度为11．4cm，中位远端切缘长度为8．5cm，中位检出淋巴结数目为29．5枚，中位术后下地时间、排气时间、进食时间和住院时间分别为1．4、3．0、3．8和6．9d。仅1例血糖控制不佳的患者术后发生切口感染，其余患者术后无腹腔出血、腹腔感染、肺部感染、肠梗阻、吻合口出血、吻合口漏和吻合口狭窄等严重并发症。结论应用腔内三角吻合技术的完全腹腔镜左半结肠切除术切实可行，安全可靠，并具有满意的近期疗效。

Objective The aim of this study was to explore the clinical safety and feasibility of intracorporeal delta-shaped anastomosis in total laparoscopic left hemicolectomy. Methods From January 1, 2017 to October 1, 2017, 11 patients who were diagnosed with left colon cancer and underwent total laparoscopic left hemicolectomy with intracorporeal delta-shaped anastomosis were retrospectively enrolled in this study. Clinicopathologic characteristics, surgical and postoperative outcomes were collected and analyzed. Results The median operation time was 121.8 minutes and the median time for anastomosis was 14.9 minutes. The median intraoperative blood loss was 45.5 ml. The lengths of the upper and lower segments of resection from colon cancer were 11.4 cm and 8.5 cm, respectively. The median number of lymph nodes retrieved was 29.5. The median time to ground activities, time to flatus, time to fluid diet intake and length of hospital stay were 1.4 days, 3.0 days, 3.8 days and 6.9 days, respectively. Only one patient suffered from incision infection during his hospitalization due to preoperative long-term smoking history. No mobility related to the anastomosis such as anastomotic bleeding, stenosis, obstruction and leakage occurred in any patients. Conclusion Total laparoseopic left hemieolectomy with intracorporeal delta-shaped anastomosis is a safe and feasible procedure with a satisfaetory short-term effect.