腹腔镜下中间入路右半结肠癌D3根治术的临床应用.docVIP

腹腔镜下中间入路右半结肠癌D3根治术的临床应用 　　[摘要] 目的 观察腹腔镜下中间入路右半结肠癌D3根治术临床应用的可行性和安全性。 方法 将本院收治的120例结肠癌患者随机分为观察组60例和对照组60例。对照组行传统开腹手术，观察组行腹腔镜下中间入路右半结肠癌D3根治术，观察两组的手术相关指标、肿瘤根治性指标、术后并发症情况。 结果 观察组平均术中出血量少于对照组（P 0.05）。观察组术后并发症的发生率为13.33%，对照组为31.67%，两组比较，差异有统计学意义（P 0.01）。结论 腹腔镜下中间入路右半结肠癌D3根治术能有效减少手术出血量，缩短手术时间、肠道排气时间、恢复流质饮食时间、住院时间，其肿瘤根治效果好，术后并发症少，具有良好的可行性和安全性。 　　[关键词] 腹腔镜；中间入路；右半结肠癌；D3根治术 　　[中图分类号] R735.3+5 [文献标识码] A [文章编号] 1674-4721（2013）06（c）-0067-02 　　The clinical application of the D3 radical operation with the laparoscopic intermediate approach for the right colon cancer 　　ZHANG Shangwen XU Tuo PENG Xuexiu 　　General Surgical Department of Peoples Hospital in Yangdong County of Guangdong Province， Yangdong 529900，China 　　[Abstract] Objective To observe the feasibility and safety of the clinical application of the D3 radical operation with the laparoscopic intermediate approach for the right colon cancer. Methods 120 cases with the right colon cancer patients in our hospital were divided randomly into the observation group （60 cases）and the control group （60 cases）.The control group underwent the conventional laparotomy while the observation group underwent the D3 radical operation with the laparoscopic intermediate approach for the right colon cancer.The related index of operation，the tumor radical index and the postoperative complications of the two groups were observed. Results The average intraoperative bleeding of the observation group was less than the control group （P 0.05）.Patients in the observation group the incidence of postoperative complications was 13.33%，control group 31.67%.Comparing the 2 groups， the difference was significant （P 　　[Key words] Laparoscopy；Intermediate approach；Right colon cancer；D3 radical operation 　　结肠癌是常见的恶性肿瘤之一。近年来，随着人们生活环境的变化、生活习惯的改变，结肠癌发病率日趋上升。临床手术治疗中，因右半结肠癌根治术需进行血管近端高位结扎，尤其是肠系膜上动脉与外科干周围血管在淋巴处理时，技术难度较大，易引起出血，给临床根治术带来较大的困难。随着腹腔镜技术、D3根治术的发展，腹腔镜下中间入路右半结肠癌D3根治术在结肠癌的手术治疗中被广泛应用，提高了手术的安全性、可靠性[1-2]。本院以2009年1月～2012年12月收治的120例结肠癌患者为研究对象，其中60例患