摘要
目的探讨下腹部外横内纵小切口取标本的全腹腔镜下右半肠癌根治术安全性及可行性。方法回顾性分析中国医学科学院肿瘤医院结直肠外科自2017年6月至2018年10月期间34例实施下腹部外横内纵小切口取标本的全腹腔镜下右半肠癌根治术的患者的临床病理资料。结果全组患者手术均顺利完成。手术时间114~295(中位数176)min;出血量10~100(中位数30)ml;肿瘤大小1.1~9.5(中位数4)cm;下腹部外横内纵小切口长度4~7(中位数5)cm。患者术后排气时间18~96(中位数38)h,术后镇痛时间26~46(中位数36)h,术后住院时间4~11(中位数6)d。术后腹腔感染2例,均未出现吻合口漏等其他并发症,术后1个月内,无二次住院患者及死亡病例,术后随访3~16个月,未见局部复发或远处转移。结论下腹部外横内纵小切口取标本的腹腔镜下右半肠癌根治术安全可行,值得在临床推广。
Objective To investigate the safety and feasibility of the total laparoscopic radical resection of the right colon cancer with a small transverse and longitudinal incisions. Methods From June 2017 to October 2018,34 patients underwent total laparoscopic radical resection of the right colon cancer with a small transverse and longitudinal incisions at Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. The data of those patients was collected and reviewed retrospectively. Results All the patients in the group completed the operation successfully. The operation time ranged from 114 to 295 min (median 176 min);Blood loss ranged from 10 to100 (median 30) ml;Tumor size ranged from 1.1 to 9.5 cm (median 4 cm);The length of the small transverse and longitudinal incisions outside the lower abdomen ranged from 4 to 7 cm (median 5 cm).The patient s postoperative exhaust time ranged from 18 to 96 (median 38) h, postoperative analgesia time ranged from 26 to 46 (median 36) h, and postoperative hospitalization time ranged from 4 to 11 (median 6) days. Abdominal infection occurred in 2 cases without anastomotic fistula and other complications. Within 1 month after surgery, there was no hospitalized patients and no death cases. Follow-up was conducted for 3-16 months after surgery, and no local recurrence or distant metastasis was found. Conclusions Total laparoscopic radical resection of right colon cancer with small transverse and longitudinal incisions is safe and feasible, and worthy of clinical promotion.
作者
陈海鹏
马晓龙
卢召
周思成
赵志勋
关旭
周海涛
梁建伟
刘正
姜争
杨明
王锡山
CHEN Haipeng;MA Xiaolong;LU Zhao;ZHOU Sicheng;ZHAO Zhixun;GUAN Xu;ZHOU Haitao;LIANG Jianwei;LIU Zheng;JIANG Zheng;YANG Ming;WANG Xishan(Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China)
出处
《中国肿瘤外科杂志》
CAS
2019年第1期10-14,共5页
Chinese Journal of Surgical Oncology
基金
国家重点研发计划精准医学研究专项(2016YFC0905300)
国家自然科学基金面上项目(81572930)
中国医学科学院肿瘤医院学科带头人奖励基金(RC2016003)
中国医学科学院医学与健康科技创新工程项目(2016-I2M-1-001)
北京市科技计划(D171100002617004)
关键词
结肠肿瘤
右半结肠切除术
完全腹腔镜
经自然腔道取标本手术
功能性端端吻合
无菌无瘤术
双套两重保护
安全性
Colon tumor
Right hemicolectomy
Complete laparoscopy
Natural orifice specimen extraction surgery
Functional end-to-end anastomosis
Aseptic tumor-free surgery
Double sets of double protection
Safety