目的:比较腹腔镜右半结肠癌完整系膜切除术（complete mesocolic excision, CME）经尾侧-中间联合入路（简称尾侧联合入路）与传统中间入路（简称中间入路）在手术学、肿瘤学等方面的效果。方法:回顾性分析2017年1月至6月收治的68例右半结肠癌病人。根据手术入路分为尾侧联合入路组37例及中间入路组31例。采用West分级系统评估比较两组的CME完成质量以及手术安全性、术后近期疗效及远期预后。结果:病人均经CME完成质量评估。尾侧联合入路组CME完成率为86.5%,中间入路组CME完成率为80.6%。两组间差异无统计学意义（P=0.53）。尾侧联合入路组腹腔镜下解剖时间较中间入路缩短[（62.70±12.22） min比（70.39±11.98） min,P=0.01]。两组病人总手术时间、术中出血量、术后排气时间、术后并发症发生及远期预后差异均无统计学意义。结论:腹腔镜右半结肠癌CME,经尾侧联合入路可缩短腹腔镜下解剖时间,CME完成质量、安全性、预后两种手术入路相当。

Objective To investigate pathologic effects combined with postoperative results on right colon cancer with laparoscopic complete mesocolic excision(CME) via dorsal-medial hybrid approach compared with traditional medial approach. Methods A total of 68 patients with right colon cancer undergoing laparoscopic CME in our hospital between Ja-nuary and June 2017 were studied retrospectively. There were two groups including 37 cases in dorsal-medial hybrid group and 31 cases in traditional medial group. CME quality evaluated with the method proposed by West et al along with safety, short-term results and long-term prognosis were compared between two groups. Results CME completion rate was 86.5% in dorsal-medial hybrid group and 80.6% in traditional medial group without statistical difference(P=0.53). Laparoscopic dissection time in dorsal-medial group was significantly shorter than that in traditional medial group[(62.70±12.22) min vs.(70.39±11.98) min, P=0.01]. There was no statistical difference in operation time, blood loss, postoperative flatus time, postoperative complications and long-term prognosis of the patients between two groups. Conclusions Laparoscopic CME via dorsal-medial hybrid approach for right colon cancer could have less laparoscopic dissection time, and two approaches were similar in CME quality, safety and prognosis.