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目的:探讨腹腔镜右半结肠切除术治疗结肠癌的安全性与有效性。方法:回顾分析2002年2月至2004年12月行腹腔镜辅助右半结肠切除术35例患者的临床资料和随访情况,以研究其手术的安全性,术后康复情况及肿瘤的根治性效果。结果:术中未发生严重并发症和死亡病例,2例(5.7%)中转开腹,手术时间(155.14±35.79)min,术中出血(111.43±87.62)ml,辅助切口长(5.69±1.00)cm,患者排气时间(2.54±1.12)d,总住院时间(14.54±6.45)d。清扫淋巴结总数14(0~50)枚,其中结肠上、旁淋巴结4(0~21)枚,系膜间淋巴结5(0~18)枚,血管根部淋巴结3(0~35)枚,手术切除标本长度(20.73±7.14)cm,肺部感染、术后腹水、腹腔局部积液、乳糜漏各1例,余者未见术后并发症,患者均获随访,平均41个月(8~68个月),2例局部复发,3例术后发生肝转移,累计生存率为76.8%。结论:腹腔镜右半结肠切除术治疗右半结肠癌安全有效,符合肿瘤根治原则。
Objective: To investigate the safety and effectiveness of laparoscopic right hemi-colon resection in the treatment of colon cancer. Methods: The clinical data and follow-up of 35 patients undergoing laparoscopic-assisted right hemi-colon resection from February 2002 to December 2004 were retrospectively analyzed to study the safety of surgery, postoperative rehabilitation and the curative effect of tumor . Results: There were no serious complications and deaths in operation, 2 cases (5.7%) were converted to laparotomy, the operation time was (155.14 ± 35.79) min, the intraoperative bleeding was (111.43 ± 87.62) ml, the length of auxiliary incision was 5.69 ± 1.00 cm, patient’s exhaust time (2.54 ± 1.12) d, total hospital stay (14.54 ± 6.45) d. There were 14 (0 ~ 50) lymph nodes dissected, of which, 4 (0 ~ 21) lymph nodes in the colon, 5 (0 ~ 18) mesangial lymph nodes and 3 (0 ~ 35) The length of the specimen (20.73 ± 7.14 cm), pulmonary infection, postoperative ascites, peritoneal effusion and chyle leakage were all observed in 1 patient. No complications were found after operation. The patients were followed up for an average of 41 months (ranging from 8 to 68 Months), 2 cases of local recurrence, 3 cases of liver metastases occurred after surgery, the cumulative survival rate was 76.8%. Conclusions: Laparoscopic right hemicolectomy is safe and effective in the treatment of right colon cancer, which accords with the principle of radical tumor.