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中华结直肠疾病电子杂志 ›› 2025, Vol. 14 ›› Issue (04) : 375 -379. doi: 10.3877/cma.j.issn.2095-3224.2025.04.011

经验交流

"Henle干孤立化解剖"在腹腔镜右半结肠癌根治术中的应用
卢新泉1, 刁德昌2, 林佳鑫1, 李洪明1, 万进1,()   
  1. 1510120 广州,广东省中医院胃肠外科
    2510655 广州,中山大学附属第六医院结直肠外科
  • 收稿日期:2024-12-09 出版日期:2025-08-25
  • 通信作者: 万进

"Isolated dissection of the Henle trunk" in radical surgery for right hemicolonic cancer

Xinquan Lu1, Dechang Diao2, Jiaxin Lin1, Hongming Li1, Jin Wan1,()   

  1. 1Department of Gastrointestinal Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120, China
    2Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China
  • Received:2024-12-09 Published:2025-08-25
  • Corresponding author: Jin Wan
引用本文:

卢新泉, 刁德昌, 林佳鑫, 李洪明, 万进. "Henle干孤立化解剖"在腹腔镜右半结肠癌根治术中的应用[J/OL]. 中华结直肠疾病电子杂志, 2025, 14(04): 375-379.

Xinquan Lu, Dechang Diao, Jiaxin Lin, Hongming Li, Jin Wan. "Isolated dissection of the Henle trunk" in radical surgery for right hemicolonic cancer[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2025, 14(04): 375-379.

目的

本文旨在探讨腹腔镜右半结肠癌根治术过程中Henle干的处理方法,即"Henle干孤立化解剖",并评价其在腹腔镜右半结肠根治术中的安全性和有效性。

方法

回顾性分析2023年6月至2023年12月广东省中医院胃肠肿瘤中心实施该方法的25例患者的临床资料,包括肿瘤基线数据、Henle干分型、手术时间、术中出血量、Henle干暴露时间、术后并发症、术后住院时间等。

结果

孤立化Henle干平均用时(9.5±1.6)min,总体平均手术时间(88.1±11.1)min。22例患者游离Henle干时达到白色界面,估算游离Henle干时出血量为3.1(0.5,8.5)mL,其中3例大于10 mL(1例12 mL,1例13 mL,1例18 mL)。术后住院时间为(5±1.5)天,平均清扫淋巴结数量(22.5±4.5)个。术后25例患者均未出现并发症,无30天内再次入院病例。

结论

"Henle干孤立化解剖"在腹腔镜右半结肠癌根治术中的应用是安全可行的,值得进一步的验证和推广。

Objective

To explore a surgical approach for handling the gastrocolic trunk, referred to as "isolated anatomical dissection of the gastrocolic trunk" and evaluate its safety and efficacy.

Methods

This study retrospectively analyzed the clinical data of 25 patients who underwent this technique in the Gastrointestinal Tumor Center of Guangdong Provincial Hospital of Traditional Chinese Medicine from June to December 2023, parameters examined included gastrocolic trunk type, operation time, intraoperative blood loss, gastrocolic trunk exposure time, postoperative complications, postoperative hospital stay, etc.

Results

The mean time to isolate the gastrocolic trunk was (9.5±1.6) min, and the overall mean operative time was (88.1±11.1) min. The estimated bleeding volume at the time of isolation of the gastrocolic trunk was 3.1 (0.5, 8.5)mL, of which 3 cases were greater than 10 mL, of which one case was 12 mL, one case was 13 mL, and one case was 18 mL. The postoperative length of hospital stay was (5±1.5) days, and the mean number of lymph nodes cleared was 22.5±4.5. There were no postoperative complications in any of the 25 cases, and there were no cases of readmission within 30 days.

Conclusion

"Isolated dissection of the gastrocolic Trunk" is a new surgical technique for laparoscopic right hemicolectomy, which is worth further verification and promotion.

图1 Henle干处理过程。1A:探寻Henle干根部、清扫223组淋巴结并离断结肠中动静脉右支;1B:拓展胰腺前间隙,游离横结肠系膜至透见胃后壁,充分游离Henle干内侧界;1C:拓展胰头、十二指肠前间隙,充分游离Henle干外侧界,孤立化Henle干;1D:分离、分辨、分别解剖Henle干及其属支;1E:孤立化解剖后的Henle干及其属支;1F:结扎离断Henle干属支(右结肠静脉)
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