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结肠系膜完整切除概念规范下的腹腔镜右半结肠癌根治术

The standardized practice of laparoscopic-assisted radical right hemicolectomy in order to achieve complete mesocolic excision

摘要:

目的 探讨结肠系膜完整切除(CME)概念规范下的腹腔镜右半结肠癌根治术的可行性.方法 2010年2月至2011年6月,对14例右半结肠癌患者施行CME概念规范下的腹腔镜右半结肠癌根治术,男性10例,女性4例;年龄36~74岁,平均57岁.TMN分期ⅡA期2例、ⅡB期3例、ⅢA期3例、ⅢB期5例、ⅢC期1例.术后病理均为腺癌.结果 全组患者均成功施行手术,无中转开腹,手术时间127~221 min,平均(178 ±37)min,术中出血量30 ~ 110 ml,平均(67±23) ml,淋巴结清扫总数14~31枚,平均(21±7)枚,术后住院时间7~15d,平均(10.0 ±2.2)d.术后2例患者出现并发症,无手术后死亡.全组患者术后随访3 ~19个月,未发现肿瘤复发或转移.结论 CME概念规范下的腹腔镜右半结肠癌根治术是安全可行的.

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abstracts:

Objective To explore the feasibility of laparoscopic-assisted radical right hemicolectomy with the outcome being a complete mesocolic excision (CME).Methods Between February 2010 and June 2011,we performed the standardized surgery of laparoscopic-assisted radical right hemicolectomy with an aim of CME on 14 patients.There were 10 males and 4 females,with an average age of 57 years ( range 36 to 74 years).All the pathologic results in 14 cases were primary colonic adenocarcinoma.The TNM stages were distributed as follows:2 in ⅡA,3 in ⅡB,3 in ⅢA,5 in ⅢB and 1 in ⅢC.Results Surgery wassuccessfully performed for all patients without open conversion.The average operation time was ( 178,± 37 ) minutes (range 127 to 221 minutes),average intraoperative blood loss was (67 ± 23 ) ml (range 30 to 110 ml),while the average number of lymph node harvest was 21 ± 7 (range 14 to 31 ),and the postoperative hospital stay was ( 10.0 ± 2.2) days (range 7 to 15 days).Minor complications occured in 2 patients.Major complications and post-operative mortality were not observed.All the patients were followed up for 3 to 19 months,no tumor recurrence or metastasis was identified. Conclusion The standardized surgery of laparoscopic-assisted radical right hemicolectomy with the final outcome of CME is safe and feasible.

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作者: 李炳根 [1] 聂向阳 [1] 何永忠 [1] 谢惠华 [1] 余国忠 [1] 杜汉朋 [1] 孔凡东 [1] 龚独辉 [1] 林伟斌 [1] 吴铭键 [1]
第一作者: 李炳根
期刊: 《中华外科杂志》2012年50卷3期 215-218页 MEDLINEISTICPKUCSCD
分类号: R735.37
栏目名称: 结直肠恶性肿瘤
DOI: 10.3760/cma.j.issn.0529-5815.2012.03.007
发布时间: 2012-04-20
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