小肠系膜根部入路腹腔镜辅助下右半结肠癌根治术20例

Laparoscopic right hemicolectomy via root of small mesentery approach for colon cancer: An analysis of 20 cases

  • 摘要: 目的 探讨小肠系膜根部入路腹腔镜辅助下右半结肠癌根治术的可行性。 方法 应用腹腔镜技术对2014年1月-2016年1月本院普通外科20例升结肠癌患者实施手术治疗,其中男15例、女5例,年龄32 ~ 70岁,平均52岁。 结果 20例均成功完成手术,无中转开腹。肿瘤大小3 ~ 5 cm。腹腔镜手术时间55 ~ 70 min,平均时间60 min。手术清扫淋巴结12 ~25枚,平均18枚。术中出血15 ~ 50 ml,平均30 ml。辅助切口平均长5 cm。平均术后住院7 d。无其他切口或穿刺口并发症发生,无肠瘘及腹腔感染等发生。术后TNM分期:ⅡA期5例、ⅡB期10例、ⅢA期5例。肿瘤分化程度:低分化腺癌6例、中分化腺癌12例、黏液腺癌2例。 结论 小肠系膜根部腹腔镜入路结合开腹手术,使得腹腔镜辅助下右半结肠癌根治术更易掌握。

     

    Abstract: Objective To evaluate the safety and curative effects of laparoscopic -assisted right hemicolectomy for right colon cancer via the approach of small mesentery root. Methods Technique of laparoscopic right hemicolectomy was performed in 20 patients with right colon cancer in our hospital from January 2014 to January 2016. Of the 20 cases, there were 15 males and 5 females with age ranging from 32-70 years (average age: 52 years). Results The operations to 20 cases were completely finished without conversion to open surgery with a median operating time of 60 min (range: 55 -70 min). The total number of resected lymph nodes was 12-25 (mean number of 18), and the volume of intraoperative blood loss was 15-50 ml (mean: 30 ml). The auxiliary incision was 5 cm long on average, and the median hospital stay was 7 days. No complications were found in this series. The classification in TNM stage after the operation included 5 cases of Ⅱ A, 10 cases of Ⅱ B, and 5 cases of Ⅲ A stage. The postoperative pathological results were 6 cases with poorly differentiated adenocarcinoma, 12 cases with medium differentiated adenocarcinoma and 2 with mucinous adenocarcinoma. Conclusion The combination of open and laparoscopic surgery via the approach of the small mesentery root makes laparoscopic right hemicolectomy more easily to be mastered.

     

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