腹腔镜下右半结肠癌根治术不同手术入路的临床疗效

Clinical Effect of Laparoscopic Radical Resection of Right Colon Cancer by Different Surgical Approaches

随着微创理念的推广与普及,右半结肠癌的治疗方式从开放性根治术向腹腔镜辅助下根治术转变,使手术性创伤显著降低,加快了患者术后功能恢复。腹腔镜辅助下的右半结肠完全结肠系膜切除术(complete mesocolic excision, CME)仍为首选术式,其手术效果对患者的预后状况起到决定性作用。但入路众多,主要有中间入路、尾侧入路。两者之间临床疗效结果尚不清楚。这给外科医师的入路选择和疗效评估带来了困惑。目前,国内学者不断进行手术入路的研究,以探索更安全、高效的手术入路。进一步优化入路方式,提高手术疗效,可减少术中出血、缩短术后肛门排气及进食时间,有利于术后恢复,也能提高患者术后生活质量。

With the promotion and popularization of the concept of minimally invasive, the treatment of right half colon cancer has changed from open radical surgery to laparoscopic assisted radical surgery, which significantly reduces the surgical trauma and accelerates the postoperative functional recov-ery of patients. Laparoscopically assisted complete mesocolic excision (CME) of the right half colon is still the preferred procedure, and its surgical results play a decisive role in the prognosis of patients. However, there are many approaches, mainly middle approach and tail approach. The clinical out-come between the two is unclear. This brings confusion to the surgeon's approach selection and ef-ficacy evaluation. At present, domestic scholars continue to study the surgical approach to explore a safer and more efficient surgical approach. Further optimization of the approach and improvement of the surgical effect can reduce the intraoperative bleeding, shorten the postoperative anal exhaust and feeding time, which is conducive to postoperative recovery and improve the postoperative quality of life of patients.