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目的探讨腹腔镜辅助右半结肠癌切除的手术方法和疗效。方法回顾性分析57例行腹腔镜辅助右半结肠癌切除手术患者的临床资料。结果51例顺利完成腹腔镜辅助右半结肠癌根治术,3例中转开腹(其中1例因肿瘤侵犯十二指肠,2例回盲部肿瘤>8 cm),3例因广泛转移仅行开关腹手术,无手术死亡。平均手术时间160(130~250)min,平均出血量110(50~150)ml,平均术后住院天数9.6(7~13)d。1例术后2 d发现肺部感染,1例术后第5 d出现不完全性肠梗阻,经对症处理后好转。57例随访6~36月,其中2例腹腔镜手术患者发生双肺部转移而死亡,1例开腹手术患者发生肝转移,1例发现Trocar穿刺处肿瘤种植并腹腔内远处转移,后2例患者放弃治疗。结论只要严格掌握手术适应证,熟练应用腹腔镜技术,腹腔镜辅助右半结肠癌切除是安全可行的。
Objective To investigate the surgical method and efficacy of laparoscopic-assisted right colon resection. Methods Retrospective analysis of 57 cases of laparoscopic assisted right colon resection in patients with clinical data. Results Of the 51 cases, laparoscopic-assisted radical resection of the right colon cancer was completed in 51 cases, laparotomy in 3 cases (1 invaded the duodenum, 2 in the ileocecal tumor> 8 cm) and 3 in the extensive metastasis Open abdominal surgery, no operative death. The average operation time was 160 (130 ~ 250) min, the average amount of bleeding was 110 (50 ~ 150) ml, the average postoperative hospital stay was 9.6 (7 ~ 13) days. One patient had pulmonary infection 2 days after operation, and one patient had incomplete intestinal obstruction on the 5th day after operation. The symptoms were improved after symptomatic treatment. Fifty-seven patients were followed up from 6 months to 36 months. Two cases died of lung metastasis in two cases of laparoscopic surgery, one case of hepatic metastasis in open surgery, one case of Trocar puncture tumor and distant metastasis in abdominal cavity, Patients give up treatment. Conclusion As long as strict indications of surgical indications, skilled application of laparoscopy, laparoscopic right colon resection is safe and feasible.