Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin Er Road, Shanghai, 200025, China.
Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin Er Road, Shanghai, 200025, China.
Surg Endosc. 2019 Mar;33(3):959-965. doi: 10.1007/s00464-018-6525-1. Epub 2018 Nov 1.
To investigate the safety and feasibility of the completely medial access by page-turning approach (CMAP) for laparoscopic right hemi-colectomy.
In this retrospective study, the data from 72 patients who underwent laparoscopic right hemi-colectomy with CMAP were analyzed and compared with data from 124 patients who underwent the conventional medial approach performed by the same surgical team from September 2011 to March 2017.
Complete mesocolic excision (CME) was achieved in 67 of 72 patients (93.1%) with laparoscopic CMAP. The average operation time, blood loss, and specimen length was 135.9 ± 28.3 min, 63.2 ± 32.2 ml, and 23.9 ± 4.7 cm, respectively. The number of lymph nodes harvested was 20.6 ± 7.7, the time-to-flatus was 2.5 ± 0.8 days, the time-to-fluid intake was 3.2 ± 0.8 days, and the average hospital stay was 8.9 ± 4.7 days. No intra-operative complications occurred in this study. The vessel-related complication and total post-operative complication rate was 2.78% (2/72) and 6.94% (5/72), respectively.
Laparoscopic CMAP was an alternative approach for CME in laparoscopic right hemi-colectomy, which was proved safe and feasible for right colon cancer.
探讨经翻转书页入路（CMAP）完全经内侧入路行腹腔镜右半结肠切除术的安全性和可行性。
本回顾性研究分析了 72 例行腹腔镜右半结肠切除术并采用 CMAP 的患者的数据，并与同一手术团队在 2011 年 9 月至 2017 年 3 月期间采用传统经内侧入路完成的 124 例患者的数据进行了比较。
腹腔镜 CMAP 组 72 例患者中 67 例（93.1%）实现了完整结肠系膜切除术（CME）。平均手术时间、出血量和标本长度分别为 135.9±28.3 min、63.2±32.2 ml 和 23.9±4.7 cm。采集的淋巴结数量为 20.6±7.7 个，肛门排气时间为 2.5±0.8 天，开始摄入液体时间为 3.2±0.8 天，平均住院时间为 8.9±4.7 天。本研究无术中并发症发生。血管相关并发症和总术后并发症发生率分别为 2.78%（2/72）和 6.94%（5/72）。
腹腔镜 CMAP 是腹腔镜右半结肠切除术 CME 的一种替代方法，对于右半结肠癌是安全且可行的。
