腹腔镜右半结肠切除术手术入路的研究现状

Research Status of Laparoscopic Right Hemicolectomy Approach

结肠癌在我国的发病率处于高位,外科手术是其主要的治疗手段。腹腔镜右半结肠切除术(LRH)作为右半结肠癌的最常用术式之一已被国际上广泛接受。但全结肠系膜切除术(CME)概念的提出使原本简单的术式趋于复杂。由于令右半结肠癌患者获得了更好的远期效果,所以逐渐成为LRH的标准方案。传统的侧方入路因为完成CME困难以及违反无瘤原则等原因已被放弃。如今能顺利完成CME的中间入路成为最受欢迎的入路,具有同样优势的尾侧入路、头侧入路、混合入路等也被学者相继提出。不同入路的选择是目前临床关注的热点话题,目前为止没有任何机构有大数据的前瞻性研究来证实LRH的最佳入路。本文重点阐述LRH手术入路的研究现状。

The incidence of colon cancer is high in China, and surgery is the main treatment. Laparoscopic right hemicolectomy (LRH) has been widely accepted as one of the most common surgical procedures for right colon cancer. However, with the introduction of the concept of total mesentery resection (CME), the original simple operation tends to be complicated. As a result of the right colon cancer patients with better long-term results, so it gradually becomes the standard program of LRH. The traditional lateral approach has been abandoned because of difficulties in completing CME and violation of the tumor-free principle. Nowadays, the middle approach which can successfully complete the CME has become the most popular approach, and the caudal approach, head approach and mixed approach with the same advantages have also been proposed by scholars. The choice of different approaches is a hot topic of clinical concern at present. So far, no organization has big data’s prospective study to confirm the best approach for LRH. This article focuses on the research status of LRH surgical ap-proach.