探讨采用经末段回肠系膜后隧道完成重叠式三角吻合的完全腹腔镜左半结肠切除术在结肠脾曲癌外科治疗中的可行性、安全性及近期疗效。

回顾性收集中国医学科学院北京协和医学院肿瘤医院2018年1月至2022年1月收治的结肠脾曲癌患者中，行经末段回肠系膜后隧道完成重叠式三角吻合的完全腹腔镜左半结肠切除手术的23例患者临床和病理资料，统计并分析患者基线资料、手术情况、术后病理情况、术后恢复及围手术期并发症等数据。

23例患者均成功施行经末段回肠系膜后隧道完成腔内吻合的完全腹腔镜左半结肠切除术。中位手术时间165 min，中位术中出血量为40 mL，中位切口长度为5.0 cm。手术标本肿瘤中位长径为4.3 cm，中位近端切缘为13.2 cm，中位远端切缘为12.1 cm，中位淋巴结检出数目为19枚。患者中位术后下地时间、进食时间、排气时间、排便时间与住院时间分别为17.5 h、12 h、33.5 h、55.5 h、5 d。随访30天内，1例患者出现腹腔感染，经抗感染保守治疗后好转。其余患者未出现切口感染、吻合口漏、腹腔出血、肠梗阻等并发症。

经末段回肠系膜后隧道行完全腹腔镜下重叠式三角吻合可应用于结肠脾曲癌患者的外科治疗，安全可行，近期疗效满意，远期疗效待进一步随访观察。

To explore the short-term outcomes of totally laparoscopic left hemicolectomy with overlapping delta-shaped anastomosis through the tunnel of terminal ileal mesentery in the surgical treatment of splenic flexure cancer.

We retrospectively collected the 23 patients diagnosed with splenic flexure cancer who underwent the totally laparoscopic left hemicolectomy with overlapping delta-shaped anastomosis through the tunnel of terminal ileal mesentery in National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital from January 2018 to January 2022. Baseline variables, surgical outcomes, pathological characteristics, postoperative recovery and complications were analyzed.

All patients have successfully undergone the totally laparoscopic left hemicolectomy with overlapping delta-shaped anastomosis through the tunnel of terminal ileal mesentery. The median operation time was 165 min. The median estimated blood loss was 40 mL and the median incisional length was 5.0 cm. With regard to pathological characteristics, the median length of tumor was 4.3 cm. The median proximal and distal resection margin was 13.2 cm and 12.1 cm, respectively. The median time to first ground activities, first oral intake, first flatus passage, first defecation, and postoperative hospital stay were 17.5 h, 12 h, 33.5 h, 55.5 h, 5 d, respectively. One patient suffered from the abdominal infection, which was controlled after antibiotic therapy. Other patients were not suffered from incisional infection, anastomotic leakage, abdominal bleeding or intestinal obstruction during the 30-day follow-up period.

Totally laparoscopic left hemicolectomy with overlapping delta-shaped anastomosis through the tunnel of terminal ileal mesentery could be applied in the surgical treatment of splenic flexure cancer with satisfactory short-term outcomes. But the long-term outcomes need to be explored.