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目的探讨应用超能剪进行腹腔镜右半结肠切除术的安全性和可行性。方法回顾性分析2010-12~2014-08应用超能剪进行腹腔镜右半结肠切除36例临床资料。结果 36例中,升结肠癌17例,结肠肝曲癌13例,盲肠癌6例。手术均顺利完成,手术时间为(161.3±55.7)min,术中出血量为(86.7±38.5)ml,术后肛门排气时间为(3.2±0.8)d,术后腹腔引流量为(290.2±67.3)ml。无输尿管损伤、吻合口瘘等并发症。清扫淋巴结5~21枚,平均12.6枚。术后获随访29例,时间为1~42个月,中位随访时间为23个月。失访7例。1例拒绝化疗的Dukes C期患者于术后9个月结肠镜检发现吻合口局部复发并经病理证实;2例Dukes C期患者分别于术后16个月(未接受化疗者)和23个月(接受正规化疗者)腹部B超及CT发现腹部包块,后经再手术病理证实为局部复发;1例Dukes C期患者于术后6个月(中途退出化疗者)B超及CT发现肝多发性转移癌。其余患者随访未见复发和转移情况。结论应用超能剪进行腹腔镜右半结肠切除安全可行,超能剪能够胜任腹腔镜右半结肠癌的根治手术。
Objective To investigate the safety and feasibility of laparoscopic right hemicolectomy with super-shearing. Methods A retrospective analysis of 2010-12 ~ 2014-08 application of super-shearing laparoscopic right colon resection in 36 cases of clinical data. Results Among the 36 cases, 17 cases of ascending colon cancer, 13 cases of colonic cancellous carcinoma and 6 cases of cecal cancer. The operation time was (161.3 ± 55.7) min, the amount of bleeding during the operation was (86.7 ± 38.5) ml, the time of postoperative anal exhaust was (3.2 ± 0.8) days and the amount of postoperative abdominal drainage was (290.2 ± 67.3) ml. No ureteral injury, anastomotic leakage and other complications. Sweeping lymph nodes 5 to 21, an average of 12.6. 29 cases were followed up for 1 ~ 42 months, the median follow-up time was 23 months. Lost in 7 cases. One of the patients with Dukes C who refused chemotherapy had local anastomotic recurrence confirmed by pathology at colonoscopy at 9 months postoperatively. Two patients with Dukes C stage were treated at 16 months (no chemotherapy) and 23 The abdominal mass was found on the B-ultrasound and CT scan of the patients who underwent formal chemotherapy and was locally recurred after re-operation. The ultrasonography and CT findings of one patient with Dukes C after 6 months Multiple liver metastases. The remaining patients were followed up no recurrence and metastasis. Conclusions It is safe and feasible to perform laparoscopic right hemicolectomy with super-shearing, and super-shearing is capable of performing laparoscopic right-colon resection.