首页|腹腔镜扩大结肠癌根治术与单纯中横结肠癌根治术解剖学及临床意义

腹腔镜扩大结肠癌根治术与单纯中横结肠癌根治术解剖学及临床意义

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目的 探索中横结肠癌解剖学及生物学特性的关联,研究术式选择的差异与预后关系,确定最佳手术方式.方法 利用解剖学和影像学数据,研究大体标本、三维血管重建图,回顾性分析中横结肠癌患者不同腹腔镜手术方式的临床效果和生存情况.结果 (1)解剖并观察大体标本,发现一、二级血管结扎可确保结肠吻合口的血液供应;(2)术前三维血管重建与术中血管探查符合率大于90％;(3)横结肠切除组与扩大结肠切除组相比,术中出血量、手术时间、术后并发症、总生存率无统计学差异,两组淋巴结清扫数目有统计学差异.结论 腹腔镜下单纯横结肠切除较扩大结肠癌根治术有降低术后并发症风险趋势,两者预后无统计学差异,横结肠切除是中横结肠癌最佳手术方式.
Anatomy and clinical significance of laparoscopic extended radical resection and simple radical resection of transverse colon cancer
Objective To explore the relationship between anatomy and biological characteristics of middle transverse colon cancer,to study the relationship between the choice of operation and prognosis,and to determine the best mode of operation.Methods Using anatomical and imaging data,gross specimens and three-dimensional vascular reconstruction maps were studied,and the clinical effects and survival of patients with middle transverse colon cancer treated by different laparoscopic operations were analyzed retrospectively.Results(1)The primary and secondary vascular ligation can ensure the blood supply of the anastomotic colon;(2)The coincidence rate of preoperative three-dimensional vascular reconstruction and intraoperative vascular exploration was more than 90％;(3)There was no statistical difference in the intraoperative bleeding volume,operation time,postoperative complications and overall survival rate between the transverse colectomy group and the expanded colectomy group.There was significant difference in the number of lymph node dissection between the two groups.Conclusions Laparoscopic transverse colectomy alone has a tendency to reduce the risk of postoperative complications compared with extended radical resection of colon cancer,and there is no statistical difference in prognosis between them.Transverse colectomy is the best surgical method for middle transverse colon cancer.

Middle transverse colon cancerSimple radical resection of middle transverse colon cancerExtended radical resection of transverse colon cancerPrognosis

曾俊、张越、刘奇、刘春生、刘志远、苏嘉睿、吴嘉伟、姚学清

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汕头大学医学院,广东 汕头 515041

南方医科大学附属广东省人民医院(广东省医学科学院)胃肠外科,普通外科,广州 510080

广东省人民医院赣州医院(赣州市立医院)普外科,江西 赣州 341000

河源市人民医院胃肠外科,广东 河源 517000

广东省心血管病研究所,广州 510080

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中横结肠癌 单纯中横结肠癌根治术 扩大结肠癌根治术 临床预后

国家临床重点专科建设项目(2021-2024)广东特支计划领军人才项目(2023-2026)广东省卫健委项目(2023-2025)

2022YW0300090620220103B2023430

2024

10.13418/j.issn.1001-165x.2024.4.07

中国临床解剖学杂志
中国解剖学会

中国临床解剖学杂志

CSTPCD北大核心
影响因子：0.7
ISSN：1001-165X
年,卷(期)：2024.42(4)