[1]刘楠 邢光远 茹东跃 刘奇 朱绍凤 陈德兴**.经自然腔道（肛门）取标本腹腔镜下右半结肠切除术6例报告[J].中国微创外科杂志,2021,01(12):1117-1120.
　Liu Nan,Xing Guangyuan,Ru Dongyue,et al.Total Laparoscopic Right Hemicolectomy With Specimen Extraction Through Natural Orifice: Report of 6 Cases[J].Chinese Journal of Minimally Invasive Surgery,2021,01(12):1117-1120.
点击复制

经自然腔道（肛门）取标本腹腔镜下右半结肠切除术6例报告()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年12期
页码:
1117-1120
栏目:
临床研究
出版日期:
2021-12-25

文章信息/Info

Title:
Total Laparoscopic Right Hemicolectomy With Specimen Extraction Through Natural Orifice: Report of 6 Cases
作者:
刘楠 邢光远 茹东跃 刘奇 朱绍凤 陈德兴**
(吉林省前卫医院普外科，长春130012)
Author(s):
Liu Nan;  Xing Guangyuan;  Ru Dongyue;  et al.
Department of General Surgery, Jilin Qianwei Hospital, Changchun 130012, China
关键词:
腹腔镜; 右半结肠切除; 经自然腔道取标本
Keywords:
Laparoscopy; Right hemicolectomy; Natural orifice specimen extraction surgery
文献标志码:
A
摘要:
目的探讨无辅助切口经自然腔道（肛门）取标本腹腔镜下右半结肠切除手术的安全性、可行性。 方法2018年 4月～2019年6月我科对6例右半结肠良性病变行完全腹腔镜下右半结肠切除术，在纤维结肠镜配合下经自然腔道（肛门）取出标本，腹部无辅助切口。结果6例均顺利完成手术，手术时间(204.8±47.4)min；术中出血量20~150 ml，中位数50 ml。术中冰冻病理均为良性或癌前病变。标本顺利经自然腔道取出。术后(23.5±7.7) h排气，进半流食时间为(42±0.8)d。住院期间1例术后发热，体温最高38.6 ℃，应用抗炎药物术后第3天体温恢复正常，无其他并发症发生。术后(10.5±2.6)d顺利出院。6例随访3～12个月，中位随访时间10个月，无并发症发生。 结论经自然腔道（肛门）取标本腹腔镜下右半结肠切除术安全、可行。
Abstract:
ObjectiveTo investigate the safety and feasibility of total laparoscopic right hemicolectomy with specimen extraction through natural orifice without auxiliary incision.MethodsA total of 6 cases of right colon benign disease in our department from April 2018 to June 2019 were treated with total laparoscopic right hemicolectomy. During the operation, the specimen was taken out through the natural orifice (anus) with the cooperation of the fiber colonoscope, without auxiliary incision in the abdomen.ResultsAll the patients were operated by natural orifice specimen extraction surgery(NOSES) with laparoscopic right hemicolectomy without conversion to laparotomy. The operation time was (204.8±47.4) min, and the median intraoperative blood loss was 50 ml (range, 20-150 ml). During the operation, the rapid pathological examination showed all lesions were benign or precancerous. The anus exhaust time after operation was (23.5±7.7) h, the time to be able to swallow semiliquid food was (4.2±0.8) d, and the total postoperative hospitalization day was (10.5±2.6) d．During the hospitalization, the body temperature reached 38.6 ℃ in only 1 case. The 6 cases were followed up for 3-12 months, with a median time of 10 months. No complications occurred.ConclusionTotal laparoscopic right hemicolectomy with specimen extraction through natural orifice is safe and feasible.

参考文献/References:

[1]中国NOSES 联盟,中国医师协会结直肠肿瘤委员会 NOSES 专委会.结直肠肿瘤经自然腔道取标本手术专家共识(2017).中华结直肠疾病电子杂志,2017,6(4):266-272.
[2]周海涛,周志祥,梁建伟,等.经肛门自然腔道标本取出的完全腹腔镜结直肠癌切除术21例临床分析.中华医学杂志,2013,93(26):2082-2084.
[3]Wang Z, Zhang XM, Zhou HT, et al. New technique of intracorporeal anastomosis and transvaginal specimen extraction for laparoscopic sigmoid colectomy. Asian Pac J Cancer Prev,2014,15(16):6733-6736.
[4]关旭,王贵玉,王锡山,等.79 家医院 718 例结直肠肿瘤经自然腔道取标本手术回顾性研究.中华结直肠疾病电子杂志,2017,6(6):469-477.
[5]邢光远,李晓勇，陈德兴.我国结直肠肿瘤经自然腔道取标本手术的发展现状.中国微创外科杂志,2020,20(6):557-560.
[6]中国 NOSES 联盟，中国医师协会结直肠肿瘤专业委员会NOSES专委会．结直肠肿瘤经自然腔道取标本手术专家共识(2019版).中华结直肠疾病电子杂志,2019,8(4):336-342.
[7]林峰，张伟，詹兴云.经自然腔道取标本的腹腔镜下右半结肠癌根治术安全性研究.中华普外科手术学杂志（电子版）,2021,15（1）:90-93.
[8]Li H，He Y，Lin Z，et al．Laparoscopic caudaltocranial approach for radical lymph node dissection in right hemicolectomy.Langenbecks Arch Surg,2016,401(5):741-746．
[9]Shapiro Ｒ，Keler U，Segev L，et al．Laparoscopic right hemicolectomy with intracorporeal anastomosis: short and longterm benefits in comparison with extracorporeal anastomosis．Surg Endosc,2016,30(9):3823-3829．
[10]黄志强，金锡御，主编.外科手术学.第3版.北京:人民卫生出版社,2010.811-815.

备注/Memo

备注/Memo:
基金项目：吉林省卫生与健康技术创新项目（2018J028）**通讯作者，Email：jlchendexing@163.com
更新日期/Last Update: 2022-04-07