摘要
目的探讨尾内侧入路单向环路式腹腔镜辅助右半结肠癌根治术的临床疗效。方法采用回顾性描述性研究方法。收集2015年1月至2016年3月中山大学附属第六医院收治的37例行尾内侧入路单向环路式腹腔镜辅助右半结肠癌根治术患者的临床资料。手术遵循无瘤原则，采用尾内侧入路单向环路式行腹腔镜辅助右半结肠癌根治术。观察指标：（1）手术情况：手术时间、术中出血量。（2）术后恢复情况：术后肛门首次排气时间、术后拔除引流管时间、术后并发症、术后住院时间。（3）术后病理学检查情况：淋巴结清扫数目、阳性淋巴结数目、标本长度、切缘情况、肿瘤病理学分期、病理学类型。（4）随访情况。采用门诊及电话方式进行随访，了解患者生存及肿瘤复发、转移情况。随访时间截至2016年6月。正态分布的计量资料以i±s表示，偏态分布的计量资料以平均数（范围）表示。结果（1）手术情况：37例患者均成功完成手术，无中转开腹，无围术期死亡患者。37例患者手术时间为（170±50）min，术中出血量为50mL（20～300mL）。（2）术后恢复情况：37例患者术后肛门首次排气时间为（3．5±1．0）d，术后拔除引流管时间为（4．3±1．1）d。术后2例患者出现伤口液化，经对症处理后好转，其余患者未发生并发症。术后平均住院时间为10d（6～21d）。（3）术后病理学检查情况：37例患者淋巴结清扫数目为（22±8）枚，其中阳性淋巴结数目为0枚（0～6枚），中央淋巴结清扫数目为（6±5）枚。标本长度为（32±9）cm，切缘均为阴性。术后肿瘤病理学分期：pT1期0例，pq2期1例，pT3期33例，pT4a期3例；pN0期23例，pNl期12例，pN2期2例。病理学类型：黏液腺癌3例，高分化腺癌7例，中分化腺癌23例，低分化腺癌4例。（4）随访情况：37例患者均获得术后随访。随访时�
Objective To investigate the clinical efficacy of unidirectional-loop caudal-medial approach for laparoscopic-assisted radical resection of right colon cancer. Methods The retrospective and descriptive study was performed. The clinical data of 37 patients who underwent laparoscopic-assisted radical resection of right colon cancer through unidirectional-loop caudal-medial approach at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2015 to March 2016 were collected. Tumor-free principle was followed and unidirectional-loop caudal-medial approach was conducted. Observation indicators included ： （ 1 ） surgical situations ： operation time, volume of intraoperative blood loss, （2） postoperative recovery： time to initial anal exsufflation, time of draining tube removal, postoperative complications, duration of postoperative hospital stay, （3） postoperative pathological examination： number of lymph node dissection, number of positive lymph node, length of specimen, incision margin, tumor pathological staging and type, （4） follow-up. All the patients were followed up using outpatient examination and telephone interview up to June 2016. Measurement data with normal distribution were presented as x ± s and measurement data with skewed distribution were presented as average （range）. Results （ 1 ） Surgical situations： 37 patients received successful operation, without conversion to open surgery and perioperative death. Operation time and volume of intraoperative blood loss in 37 patients were （170 ± 50）minutes and 50 mL （range, 20-300 mL）. （2） Postoperative recovery： time to initial anal exsufflation, time of draining tube removal and average duration of postoperative hospital stay were （ 3.5 ± 1. 0）day, （4.3 ± 1. 1 ） （lays and 10 days （ range, 6- 21 days）, respectively. Two patients with postoperative wound liquefaction were improved by symptomatic treatment,and the other patients had no complication. （3）Postoperative pathological exa
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2016年第9期928-932,共5页
Chinese Journal of Digestive Surgery
基金
广东省科技计划项目（2013B0Z2000060）
中山大学临床医学研究5010计划项目（2016005）
关键词
结肠肿瘤
全结肠系膜切除
尾内侧入路
单向环路
腹腔镜检查
Colonic neoplasms
Tolal mesocolic excision
Caudal-medial approach
Umidirectional-loop
Laparoscopy
