探讨头侧-尾侧-中间入路行腹腔镜右半结肠癌根治术的临床3年随访研究。

回顾性分析2015年1月至2017年4月收治的83例右半结肠癌患者资料，均接受腹腔镜右半结肠癌根治术治疗。根据术中入路方式不同分为两组，将中间入路的40例患者纳入中间入路组，将以头侧-尾侧-中间入路的43例患者纳入混合入路组。采用SPSS 24.0软件进行数据处理，手术相关指标、术后恢复情况等计量资料以(±s)表示，采用独立t检验；并发症、复发率及转移率等计数资料采用χ²检验，P<0.05为差异有统计学意义。

混合入路组手术时间、术中出血量均比中间入路组少(P<0.05)；两组肛门排气时间、初次饮食时间、腹腔引流时间、住院时间、术中淋巴结清扫数量、术后3年复发率及转移率相比，差异均无统计学意义(P>0.05)。混合入路组并发症总发生率比中间入路组低(7.0% vs. 22.5%)。

与中间入路相比，头侧-尾侧-中间入路行腹腔镜右半结肠癌根治术可有效缩短手术时间，减少术中出血量，进而降低术后并发症风险。

To investigate the 3-year clinical outcome of laparoscopic radical right hemicolectomy for colon cancer through cephalic-caudal-middle approach.

From January 2015 to April 2017, clinical data of 83 patients with right hemicolon cancer who received laparoscopic radical right hemicolectomy were analyzed retrospectively . According to the intraoperative approach, 40 cases who received tractional intermediate approach were divided into the intermediate approach group, and 43 cases who received cephalic-caudal-middle approach were divided into the mixed approach group. Statistical software SPSS20.0 were used for data analysis. Measurement data such as surgical indicators and postoperative recovery were expressed as (±s), and were examined by using independent t test. Count data such as complications, recurrence rate, and metastasis rate were expressed as percentages, and chi-square test was used, A P value of <0.05 was considered as statistically significant difference.

The operation time and intraoperative blood loss in the mixed approach group were lower than those in the intermediate approach group respectively (P<0.05). There were no significant difference between χ² groups in terms of anal exhaust time, initial diet time, abdominal drainage time, length of hospital stay, number of lymph node dissections, recurrence rate and metastasis rate at 3 years after operation (P>0.05). The total incidence of complications in the mixed approach group was much lower than in the intermediate approach group (7.0% vs. 22.5%), with significant difference (P<0.05).

Compared with the intermediate approach, the cephalic-caudal-middle approach could effectively shorten the operation time, reduce intraoperative blood loss and reduce the risk of postoperative complications.