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1、腹腔镜右半结肠切除术35例临床分析作者：李华青，李健文*，郑民华，孙延军,朱倩林单位：上海交通大学附属瑞金医院，上海【摘要】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：冋顾分析2002年2月至2004年12月行腹腔镜辅助右半结肠切除术35例患者的临床资料和随访情况，以研究其手术的安全性，术后康复情况及肿瘤的根治性效果。结杲：术中未发生严重并发症和死亡病例,2例(5.7%)中转开腹,手术时间(155.14±35.79)min,术中出血(111.43±87.62)ml,辅助切口长(5.69±1.00)cm,患者排气时间(2.54
2、±1.12)d，总住院时间(14.54±6.45)do清扫淋巴结总数14(0〜50)枚,其中结肠上、旁淋巴结4(0〜21)枚，系膜间淋巴结5(0〜18)枚，血管根部淋巴结3(0〜35)枚，手术切除标木长®(20.73±7.14)cm,肺部感染、术厉腹水、腹腔局部积液、乳糜漏各1例，余者未见术后并发症，患者均获随访，平均41个月(8〜68旅),2例局部复发，3例术后发生肝转移，累计生存率为76.8%。结论：腹腔镜右半结肠切除术治疗右半结肠癌安全有效，符合肿瘤根治原则。【关键词】右半结肠切除术；结肠肿瘤；根治切除；腹腔镜术Theclinicalan
3、alysisoflaparoscopicassistedrighthemicolectomy:areportof35casesLIHuaqing,LIJianwen,ZHENGMinhua.etal.Dept.ofGeneralSurgeryofRuijinHospital,ShanghaiJiaotongUniversity,ShanghaiMinimallyInvasiveSurgeryCenter,Shanghai200025,China[Abstract]0bjective:Toexplorethefeasibilityandsafetyoflaparoscopicassist
4、edrighthemicolectomyforcoloniccarcinoma.Methods:Thesafetyofoperation,statusofrecovery,complication,oncologicalcleaninceandresultsofshorttermfollowupwerestudiedin35patientsunderwentlaparoscopicassistedrighthemicolectomyforcoloniccancerbetweenFeb.2002andDec.2004.Results:Twocases(5.7%)wereconverted
5、toopensurgery.Theaverageoperativetimewas(155.14±35.79)minandthebloodlosswas(111.43±87.62)ml.Theaverageincisionlengthwas(5.69±l.00)cm.Theaveragetimeforpassageofflatusandhospitalizationwere(2.54±1・12)d,(14・54±6-45)drespectively.Thetotalnumberoflymphnodesremovedwa
6、s14(0〜50),andtheaveragelengthofspecimenremovedwas(20.73±7・14)cm.Complilationswereobservedin4of35patients.thatwerepulmonaryinfection,abdominalpartfluidify,abdominaldropsyandchylusleak.Theaveragefollowuptimewas41months(868months).Thecumulativesurvivalrateat41monthswas76.8%・Conclusions:Lapar
7、oscopicassistedrighthemicolectomycanbesuccessfullyperformedforrightcoloncarcinomawithalltheadvantagesofminimallyinvasivesurgery.【Keywords]Righthemicolectomy;Colonicneoplasms;Radicalresection;Laparoscopy1991年hicobs等[1]报道了第一例腹
