全结肠系膜切除应用于腹腔镜辅助右半结肠癌根治术的安全性及疗效分析

目的探讨全结肠系膜切除在腹腔镜右半结肠切除术中的安全性及短期疗效。方法回顾性分析北京大学肿瘤医院胃肠肿瘤微创外科2009年4月至2011年11月连续收治的70例右半结肠癌患者的临床资料。结果共有65例行腹腔镜全结肠系膜切除右半结肠癌切除术患者纳入研究，全组患者手术时间120～285（中位时间185）min，术中出血量30～150（中位50）ml；中位淋巴结清扫数24枚／例；术后并发症发生率9．2％（6／65），术后中位排气时间3d，术后住院时间7d。无30d内再住院患者及死亡患者。全组患者的2年总生存率为98．5％，2年无病生存率为83．1％。结论在腹腔镜右半结肠切除术中应用全结肠系膜切除技术．可以达到肿瘤的根治性完整切除：且可发挥腹腔镜手术术中出血少、术后恢复快的优势，并未增加手术风险，术后短期随访疗效良好。

Clinical analysis of laparoscopic complete mesocolic excision in right colectomy

Objective To investigate the application and short-term efficacy of laparoscopic complete mesocolic excision in fight colectomy. Methods The data of continuous 70 cases of ascending colon cancer enrolled in the Peking University Cancer Hospital ＆ Institute between April, 2009 and November, 2011 were analyzed retrospectively. Results A total of 65 cases received laparoseopic CME procedure and were enrolled in the final analysis. The median number of lymph nodes retrieved was 24, the median operation time was 185 rain, the median blood loss was 50 ml. The overall postoperative complication rate was 9.2%（6/65）, and the median time of first flatus and post-operative hospital stay was 3 days and 7 days respectively. The median 30-day hospital readmission and postoperative death were not found. The 2-years overall survival rate and disease-free survival rate were 98.5% and 83.1% respectively. Conclusions Laparoscopic complete mesocolic excision in fight colectomy is feasible and do not give patients extra burden. The short-term follow up reveals good efficacy.