摘要
目的:探讨手辅助腹腔镜(hand-assisted laparoscopic surgery,HALS)左半结肠根治性切除术的安全性及可行性.方法:对南昌大学第一附属医院41例结肠癌患者采用HALS左半结肠根治性切除术的临床资料进行回顾性分析,分析其临床应用价值.结果:本组患者手术均成功实施,无损伤脾脏而行脾切除者,无手术死亡病例.平均手术时间136.0 min±21.0 min,出血量为87.0 m L±13.0 m L,术后病理淋巴结清扫数为11.0枚±5.0枚,术后平均住院时间为7.0 d±4.0 d,术后患者疼痛轻,切口长度平均长6.0 cm±1.5 cm.术后无大出血、吻合口瘘、肠梗阻等严重并发症,均顺利出院.术后中位随访时间为29.5m o(3-48 m o),其中2例患者因肝转移死亡,1例患者因腹腔广泛转移死亡,本组病例3年累积生存率为83.6%.结论:运用HALS左半结肠根治性切除术治疗左半结肠癌是安全可行的,初步可以达到微创外科和肿瘤根治性的要求,远期疗效还需进一步研究.
AIM： To assess the clinical value of hand-assisted laparoscopic （HALS） left hemicolectomy.
METHODS： The clinical data for 41 patients who underwent HALS left hemicolectomy at our hospital were retrospectively analyzed.
RESULTS： All patients successfully recovered after HALS surgery. No patients had spleen injury and underwent splenectomy. No operative deaths occurred. Mean operative time was 136.0 min ± 21.0 min. Average amount of bleeding was 87.0 mL ± 13.0 mL. The number of harvested lymph nodes for postoperative pathological examination was 11.0 ± 5.0. Mean postoperative hospital stay was 7.0 d ± 4.0 d. The procedure had the advantage of mild pain. The average length of incision was 6.0 cm ± 1.5 cm. There was no severe operative complications like hemorrhage, anasnomotic leak, intestinal obstruction, etc. The median follow-up duration was 29.5 （3-48） mo, and there were three deaths during follow-up, 2 due to liver metastasis and 1 to peritoneal metastasis. The 3-year cumulative survival rate of the patients was 83.6%.
CONCLUSION： HALS in colon cancer is feasible and safe. The procedure basically reaches the required standard for minimally invasive surgery and radical resection of tumor; however, its long-term outcome needs further investigation.
出处
《世界华人消化杂志》
CAS
北大核心
2014年第35期5561-5566,共6页
World Chinese Journal of Digestology
关键词
结肠癌
手辅助腹腔镜
左半结肠切除术
微创外科
Colon cancer
Hand-assisted surgery
Left hernicolectomy
Minimally invasive
