临床肿瘤学杂志

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改良三角吻合技术在结肠癌腹腔镜右半结肠切除术后消化道重建中的应用

史磊,梁建伟,周海涛,王征,王鹏,周志祥   

  1. 100021 北京国家癌症中心 中国医学科学院北京协和医学院肿瘤医院结直肠外科
  • 收稿日期:2017-02-03 修回日期:2017-03-01 出版日期:2017-04-30 发布日期:2017-04-30
  • 通讯作者: 周志祥

Application of improved delta-shaped anastomosis for digestive tract reconstruction in laparoscopic right hemicolectomy of colon cancer

SHI Lei,LIANG Jianwei,ZHOU Haitao,WANG Zheng,WANG Peng,ZHOU Zhixiang   

  1. Department of Colorectal Surgery,National Cancer Center/Cancer Hospital,Chinese Academy of Medical Scienses and Peking Union Medical College,Beijing 100021,China
  • Received:2017-02-03 Revised:2017-03-01 Online:2017-04-30 Published:2017-04-30
  • Contact: ZHOU Zhixiang

摘要: 目的 探讨改良三角吻合技术应用于结肠癌腹腔镜右半结肠切除术后消化道重建的可行性及安全性。方法 回顾性分析2013年1月至2016年12月行结肠癌腹腔镜右半结肠切除术并行回肠-结肠三角吻合的135例患者的临床资料,观察手术时间、术中出血量、术后排气时间、术后住院天数等指标。结果 135例患者均行腹腔镜辅助右半结肠切除术,并接受回肠结肠改良三角吻合。中位手术时间为140 min,中位失血量为50 ml,术后中位排气时间为2天,术后中位住院时间为10天。全组患者均无吻合口瘘、吻合口出血、吻合口狭窄等并发症出现。结论 在结肠癌腹腔镜右半结肠切除术后,行回肠结肠改良三角吻合术可行性强,安全性高,是理想的消化道重建方式之一。

Abstract: Objective To evaluate the feasibility and safety of improved delta-shaped anastomosis in the process of laparoscopic right hemicolectomy for digestive tract reconstruction in patients with colon cancer. Methods From January 2013 to December 2016,one hundred and thirty-five patients were treated with laparoscopic right hemicolectomy and improved delta-shaped anastomosis,and the data of these patients were collected and analyzed to assess the value of this technique. Results One hundred and thirty-five patients were all successfully performed by laparoscopic right hemicolectomy and improved delta-shaped anastomosis. The median operation time was 140 minutes. The median blood loss was 50 ml. The median time from surgery to first flatus was 2 days and the median time from surgery to discharge was 10 days. There were no anastomotic related complications such as leakage,hemorrhage and stenosis. Conclusion Improved delta-shaped anastomosis is a safe and reliable technique for ileocolostomy and appeared to be an ideal method of digestive tract reconstruction for laparoscopic right hemicolectomy.

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