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目的:探讨腹腔镜下右半结肠癌根治术的安全性及远期疗效。方法:回顾分析2002年2月至2009年3月间177例行腹腔镜下右半结肠癌D3根治术病人的临床资料,研究其手术安全性及近远期疗效。结果:本研究病人的平均手术时间(132.6±35.7)min,术中出血(94.2±34.1)mL,术后肠道排气时间、恢复流质饮食时间、术后住院天数分别为(2.13±0.74)d、(3.21±0.45)d、(10.35±2.72)d;平均切除标本长度(17.32±8.26)cm,淋巴结清扫数目(15±8)枚。中转开腹5例(2.82%),腹腔镜手助切除4例(2.26%)。并发症24例(13.56%)。术后随访39(12～97)个月,随访期内发现1例戳创孔肿瘤种植,局部复发5例(2.82%),远处转移7例(其中肺转移2例,肝转移4例,骨转移1例)。累计生存率、无病生存率及肿瘤相关生存率分别为83.69%、80.43%及83.14%。Dukes A期、B期、C期的5年生存率分别为93.23%、76.47%、66.67%。结论:腹腔镜右半结肠癌根治术是安全且符合肿瘤根治原则的,并能获得令人满意的近、远期疗效。
Objective: To investigate the safety and long-term efficacy of laparoscopic right colon resection. Methods: The clinical data of 177 patients undergoing laparoscopic right colon cancer with D3 radical operation from February 2002 to March 2009 were retrospectively analyzed. The safety and short-term and long-term efficacy of the surgery were studied. Results: The mean operative time (132.6 ± 35.7) min, intraoperative bleeding (94.2 ± 34.1) mL, postoperative intestinal excretion time, the time of restoring the liquid diet, the postoperative hospital stay were (2.13 ± 0.74) d, (3.21 ± 0.45) d and (10.35 ± 2.72) d, respectively. The average length of resected specimens was 17.32 ± 8.26 cm and the number of lymph node dissection was 15 ± 8. Metastasis in 5 cases (2.82%), laparoscopic hand-assisted resection in 4 cases (2.26%). Complications in 24 cases (13.56%). A follow-up period of 39 (12-97) months was followed up. One case of punctured hole tumor was found during the follow-up period. Local recurrence was found in 5 cases (2.82%) and distant metastasis in 7 cases (2 cases of lung metastasis, 4 cases of liver metastasis, Bone metastasis in 1 case). The cumulative survival rate, disease-free survival rate and tumor-related survival rate were 83.69%, 80.43% and 83.14% respectively. The 5-year survival rates of Dukes A, B and C were 93.23%, 76.47% and 66.67% respectively. Conclusions: Laparoscopic right-sided colon cancer radical surgery is safe and in line with the principle of radical tumor treatment, and can obtain satisfactory short-term and long-term effects.