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目的:探讨腹腔镜下完整结肠系膜切除术在左半结肠癌中的应用。方法:回顾性分析本院2012年1月到2015年7月同一手术组收治的55例左半结肠癌患者的临床资料和随访情况。结果:无围手术期死亡,中转开腹1例,中转率1.82%(1/55)。平均手术时间(106.8±30.7)min、平均出血量(51.2±15.4)m L。平均肠管切除长度(24.3±5.1)cm、平均淋巴结清扫数目(17.4±5.6)枚。无吻合口漏及吻合口出血。平均肛门排气时间(2.9±1.5)d、平均术后住院时间(8.6±2.8)d,近期并发症发生率9.1%(5/55),包括切口感染3例,乳糜漏1例,腹腔脓肿1例。术后随访3~42个月,1例腹腔内复发、2例死亡,术后2年的总生存率95.8%。结论:腹腔镜下左半结肠完整结肠系膜切除术是安全可行的、近期效果可,长期疗效有待进一步的探索。
Objective: To investigate the application of laparoscopic complete mesorectal excision in left-sided colon cancer. Methods: The clinical data and follow-up of 55 patients with left-sided colon cancer admitted to our hospital from January 2012 to July 2015 in our hospital were retrospectively analyzed. Results: There was no perioperative death, 1 case was converted to laparotomy, and the conversion rate was 1.82% (1/55). The average operation time (106.8 ± 30.7) min, average blood loss (51.2 ± 15.4) m L. The average length of resection (24.3 ± 5.1) cm and the average number of lymph nodes dissection (17.4 ± 5.6) pieces. No anastomotic leakage and anastomotic bleeding. The average time of anus discharge was (2.9 ± 1.5) days, the average length of postoperative hospital stay was (8.6 ± 2.8) days, and the incidence rate of recent complications was 9.1% (5/55). Including incision infection in 3 cases, chylous leakage in 1 case, abdominal abscess 1 case. The patients were followed up for 3 to 42 months. One case had intraperitoneal recurrence and two died. The overall survival rate was 95.8% after 2 years. Conclusion: Laparoscopic complete colon mesenteric resection of the left colon is safe and feasible. The short-term effect may be needed and the long-term therapeutic effect remains to be further explored.