标题：扩大右半结肠切除术在梗阻性结肠脾曲肿瘤中的应用

      作者：常顺伍，吕云福
    (海南省人民医院胃肠外一科，海南 海口 570311)

      卷次： 2015年26卷18期

      【摘要】 目的 探讨扩大右半结肠切除术治疗结肠脾曲肿瘤并急性梗阻的临床疗效。方法 回顾性分析我院
2005年6月至2014年11月期间由同一术者实施的11例梗阻性结肠脾曲肿瘤行扩大右半结肠切除手术患者的临床资
料，针对患者的手术时间、术中出血量、术后排气时间、住院时间、淋巴结清扫数目及术后吻合口瘘的发生率等方面
进行观察。结果 本组均除外Ⅳ期患者。11例患者TNM分期中ⅡC期2例，ⅢB期4例，ⅢC期5例。平均手术时间
(195.7±17.1) min，平均术中出血量(272.6±54.8) ml，平均术后排气时间(4.2±2.6) d，平均住院时间(11.5±6.8) d，术后3个
月平均每日排便次数为3.5次/d。淋巴结的中位清扫数为13.8枚，淋巴结阳性比例为44%。3例患者淋巴结清扫数不
足12枚(27.3%)。11例患者手术切缘均为肿瘤阴性。术后无一例患者发生吻合口瘘。结论 在充分掌握适应证
的情况下，结肠脾曲肿瘤并急性梗阻行扩大右半结肠切除一期吻合术安全可行。

      【关键词】 扩大右半结肠切除术；结肠脾曲肿瘤；肠梗阻

      【中图分类号】 R656.9 【文献标识码】 A 【文章编号】 1003—6350（2015）18—2755—03


Application of extended right colectomy in the treatment of obstructive splenic flexure tumours.
CHANG Shun-wu,
LV Yun-fu. Department of Ggastrointestinal Surgery, People's Hospital of Hainan Province, Haikou 570311, Hainan, CHINA

【Abstract】 Objective To evaluate the clinical efficacy of extended right colectomy in treating obstructive splenic
flexure tumour. Methods The clinical and follow-up data of 11 patients who underwent extended right colectomy from
June 2005 to november 2014 in our hospital were retrospectively analyzed. The operation time, intraoperative blood loss,
postoperative exhausting time, length of hospital stay, number of lymph nodes dissected and incidence of postopera-
tive anastomotic fistula were analyzed. Results According to the TNM staging, there were 2 phaseⅡC cases, 4 phase
ⅢB cases, and 5 phase ⅢC cases. The mean operation time was (195.7 ± 17.1) min, intraoperative blood loss was
(272.6.0±54.8) ml, postoperative exhausting time was (6.2±2.3) d, length of hospital stay was (11.5±6.8) d, and stool fre-
quency was 3.5 times per day 3 months after the surgery. The median number of dissected lymph nodes was 13.8, with pos-
itive lymph nodes in 44% of patients. The proportion of patients with <12 dissected lymph nodes was 27.3%. All patients
had negative resection margins. And postoperative anastomotic fistula developed in no patients. Conclusion Extended
right colectomy for patients with obstructive splenic flexure tumours is feasible and safe.