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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:对2000年9月至2003年10月我科为41例右半结肠癌病人所行的腹腔镜右半结肠切除术进行随访,以研究其手术安全性、术后恢复情况及肿瘤的根治性效果。结果:无术中严重并发症和手术死亡病例,2例(4.9%)中转开腹手术;手术时间为(152.65±28.29)min、术中出血平均(112.94±96.36)ml。病人排气时间、下床时间、住院天数分别为(2.24±0.56)、(3.94±1.64)、(13.94±6.5)d。清扫淋巴结总数(11.24±8.02)枚[结肠上旁淋巴结(6.82±4.72)枚,系膜间淋巴结(2.59±2.43)枚,血管根部淋巴结(1.82±2.53)枚],手术切除标本长度(20.88±5.28)cm;除2例肺部感染、1例术后肠梗阻外余病人未见术后并发症;所有病人均获随访(12～46)个月,平均(29.15±7.95)个月,2例(4.9%)局部复发,3例(7.3%)发生肝转移,短期(46个月)累计生存率为74.50%。结论:腹腔镜右半结肠切除术治疗右半结肠癌是安全有效的,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: From September 2000 to October 2003, 41 patients with right colon cancer underwent laparoscopic right hemi-colon resection in our department. All patients were followed up for safety, postoperative recovery and radical treatment Sexual effects. Results: There were no serious intraoperative complications and surgical deaths. Two cases (4.9%) underwent laparotomy. The operation time was (152.65 ± 28.29) min and the mean intraoperative bleeding was (112.94 ± 96.36) ml. The time of exhausting, the time of getting out of bed and the days of hospitalization were (2.24 ± 0.56), (3.94 ± 1.64) and (13.94 ± 6.5) days respectively. The total number of lymphadenectas (11.24 ± 8.02), colonic lymph nodes (6.82 ± 4.72), mesangial lymph nodes (2.59 ± 2.43), and vascular root lymph nodes (1.82 ± 2.53), the length of resected specimens (20.88 ± 5.28) cm. No postoperative complications were found in 1 case of postoperative intestinal obstruction except for 2 cases of pulmonary infection. All cases were followed up for 12 to 46 months, with an average of (29.15 ± 7.95) months, 2 Local recurrence occurred in 4 cases (4.9%), liver metastases in 3 cases (7.3%), and cumulative survival rate in short term (46 months) was 74.50%. Conclusion: Laparoscopic right hemi-colon resection for right colon cancer is safe and effective, in line with the principle of radical tumor.