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目的探讨腹腔镜右半结肠癌根治术的安全性、可行性及临床疗效。方法从2013年1月至2014年9月行腹腔镜右半结肠癌根治术30例。术前经结肠镜病理检查活检病理证实:盲肠部癌13例、升结肠癌11例、结肠肝曲癌6例。术前行CT或MRI评估,TNM分期为Ⅰ期6例、Ⅱ期18例、Ⅲ期6例。对该临床资料进行分析。结果 30例右半结肠癌患者无中转开腹手术,手术时间平均126 min,术中失血量平均为36 ml,平均检出淋巴结13枚,术后3 d肠蠕动恢复肛门排气,术后未发生与手术相关并发症,术后平均9 d出院。术后病理为Ⅰ期4例、Ⅱ期18例、Ⅲ期8例。术后30例全部获得随访3~20个月,平均10个月,局部无肿瘤复发,均生存。结论腹腔镜右半结肠癌根治术,采用中间入路,安全可行,临床期疗效满意。
Objective To investigate the safety, feasibility and clinical efficacy of laparoscopic right colon cancer radical operation. Methods From January 2013 to September 2014, 30 patients underwent laparoscopic right colon cancer surgery. Preoperative biopsy by colonoscopy pathology confirmed: cecal cancer in 13 cases, ascending colon cancer in 11 cases, 6 cases of colon cancer. Preoperative evaluation of CT or MRI, TNM staging stage Ⅰ 6 cases, Ⅱ 18 cases, Ⅲ 6 cases. The clinical data for analysis. Results 30 cases of right colon cancer patients without transit laparotomy, the average operation time was 126 min, the average blood loss during operation was 36 ml, an average of 13 lymph nodes were detected, 3 days postoperative bowel movements to restore anus exhaust, postoperative Complications related to surgery occurred and were discharged on average after 9 days. Postoperative pathology was stage Ⅰ in 4 cases, stage Ⅱ in 18 cases and stage Ⅲ in 8 cases. All 30 cases were followed up for 3 to 20 months, with an average of 10 months. There was no local tumor recurrence and all survived. Conclusion Laparoscopic right colon cancer radical surgery, the use of the middle approach, safe and feasible, clinical efficacy satisfactory.