作者：王伟1，罗思静2，熊文俊1，郑燕生1，罗立杰1，王玉颖2，朱晓峰2，薛玉玲2，徐钰婷2，彭耀辉2

单位：1.广州中医药大学第二附属医院 胃肠外科，广东 广州 510120； 2.广州中医药大学，广东 广州 510405

Authors:  WANG Wei1, LUO Sijing2, XIONG Wenjun1, ZHENG Yansheng1, LUO Lijie1, WANG Yuying2, ZHU Xiaofeng2, XUE Yuling2, XU Yuting2, PENG Yaohui2

Unit:  1.Department of Gastrointestinal Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong, China;  2.Guangzhou University of Chinese Medicine Guangzhou 510405, Guangdong, China

摘要：

目的  探讨腹腔镜下腹主动脉旁淋巴结清扫术在左半结肠癌的安全性及可行性。方法  回顾性分析2018年1月至2018年10月在广东省中医院进行的腹腔镜左半结肠癌根治术联合腹主动脉旁淋巴结清扫术患者4名,分析患者基线资料、术中和术后结果。结果  4名患者均顺利完成手术,无中转开腹,术中无脏器损伤及大出血等并发症,术后无腹腔出血、胰瘘、乳糜瘘等严重并发症。中位手术时间为315(310-325) min,术中中位失血量为105(100-120) ml,中位淋巴结清扫数目35(31-50)个,中位腹主动脉旁淋巴结总数22 (16-26)个,中位阳性腹主动脉旁淋巴结数量为1个(0-5)。4名患者均于术后2天离床活动,术后排气时间为2(1-4)天,恢复流质饮食时间为4(3-5)天,术后中位住院时间为7.5(7-10)天。结论  腹腔镜左半结肠癌根治术联合腹主动脉淋巴结清扫术是安全可行的。

关键词： 腹腔镜; 左半结肠癌; 腹主动脉旁淋巴结清扫

Abstract：

Objective  Para-aortic lymphadenectomy in colon cancer is controversial. We aim to explore the safety and feasibility of laparoscopic para-aortic lymph node dissection in left-sided colon cancer. Methods  From January 2018 to October 2018,4 consecutive patients underwent laparoscopic left-sided colon cancer radical surgery and para-aortic lymphadenectomy. The baseline characteristics, intra-operative and postoperative outcomes were prospective collected and reviewed retrospectively. Results  4 patients were included and all operations were completed without death. No intra-operative complication was recorded. The median operating time was 315 minutes (range, 310–325 minutes) and the median estimated bloodloss was 105 mL (range, 100–120 mL). The median number of para-aortic lymph nodes harvest was 22 (16 to 26) and the median number of Positive para-aortic lymph nodes was 1 (0 to 5). The median time of first flatus was 2 days. The median hospital stay was 7.5 (7 to 10) days. Conclusions  Laparoscopic para-aortic lymphadenectomy is safe and feasible.

Key Words:  Laparoscopic; Left-sided colon cancer; Para-aortic lymph node dissection