改良两孔腹腔镜右半结肠切除术疗效分析.docVIP

改良两孔腹腔镜右半结肠切除术疗效分析 　　 　　[摘要] 目的 评估改良两孔腹腔镜右半结肠切除术治疗结肠肿瘤的临床效果及安全性。 方法 回顾性分析实施改良两孔腹腔镜右半结肠切除术的18例患者的临床资料和复诊情况。 结果 手术过程中未发生严重并发症和死亡病例，手术时间为（162.2±32.6） min，术中出血量为（102.2±35.6） ml，术后平均住院时间为（9.6±3.2） d，肠道排气时间为（2.02±0.67） d，清扫淋巴结数量为（14.5±2.5）枚，其中2例中转为开腹手术。术后随访1~36个月，局部复发再手术2例，半年内局部复发加肝转移1例，最长3年内无死亡病例。 结论 改良两孔腹腔镜右半结肠切除术治疗结肠肿瘤，手术安全性高、并发症发生率低、疗效好、康复快，具有更好的微创和美容效果，是治疗结肠肿瘤的有效治疗手段。 　　[关键词] 两孔法；腹腔镜；右半结肠切除手术 　　[中图分类号] R735.3[文献标识码] B[文章编号] 1674-4721（2014）05（a）-0143-03 　　 　　The effect analysis of improved two-hole laparoscopic right colectomy 　　WANG Yuan LI Xiao-hui ZHANG Wei-liang WANG Jin-xiang 　　Department of Surgery,Puning People′s Hospital of Guangdong Proivnce,Puning 515300,China 　　[Abstract] Objective To explore the feasibility and safety of improved two-hole laparoscopic right colectomy in the treatment of colonic carcinoma.Methods The clinical data and follow-up situation were studied in 18 cases of patients with colonic cancer underwent improved two-hole laparoscopic right colectomy.Results No serious complications and deaths occured in the process of operation.The average operative time was (162.2±32.6) min,the blood loss was (102.2±35.6) ml,the average time of hospitalization was (9.6±3.2) d,intestinal exhaust time was (2.02±0.67) d,number of dissected lymph nodes was (14.5±2.5);Two cases were converted to open surgery.The average follow up time was 1-36 months.2 cases was local recurrence and reoperation,1 case was local recurrence and had liver metastasis within half a year,no death case in the 3 years after operation.Conclusion Improved two-hole laparoscopic right colectomy for colonic carcinoma is safe,with low complication rate,good curative effect and faster recovery,which has a better minimally invasive and cosmetic effect that is an effective therapy for the treatment of colon cancer. 　　[Key words] Two-hole;Laparoscopy;Right colectomy 　　腹腔镜技术近年来应用于胃肠道疾病的治疗日渐成熟，传统腹腔镜右半结肠切除术采用的是5孔+小切口辅助法。随着技术水平的提高，腹腔镜手术的孔数也在逐步减少，从5孔法至单孔法临床上均有不少报道[1]。孔数越少肯定美容效果更佳，但操作难度也相应