比较3种不同吻合方式在腹腔镜右半结肠癌根治术中的安全性及近期疗效。

回顾性分析2018年1月至2024年12月在中山市人民医院行腹腔镜右半结肠癌根治术的257例患者临床资料。其中，端侧组54例，行回肠-横结肠端侧吻合；逆蠕动组133例，行回肠-横结肠逆蠕动侧侧吻合；顺蠕动组70例，行回肠-横结肠顺蠕动侧侧吻合。比较3组患者术中情况、术后近期并发症发生情况以及术后早期恢复情况。

3组患者基本资料差异无统计学意义，顺蠕动组手术时间长于端侧组与逆蠕动组，而逆蠕动组术中出血量少于端侧组（P<0.001）。3组术后排气时间、术后住院时间差异无统计学意义，而端侧组术后复查白细胞和中性粒细胞计数显著低于其他两组（P<0.01）。3组各手术并发症如吻合口瘘、吻合口出血、肠梗阻、胃瘫、腹腔出血、切口感染等发生率差异无统计学意义。

不论是端侧吻合、逆蠕动侧侧吻合还是顺蠕动侧侧吻合，在腹腔镜右半结肠癌根治术中都是安全且有效的，可根据患者病情及术中情况选择适合的吻合方式。

To compare the safety and short-term outcomes of three different anastomotic techniques in laparoscopic radical right hemicolectomy for colon cancer.

A retrospective analysis was conducted on 257 patients who underwent laparoscopic radical right hemicolectomy in Zhongshan City People’s Hospital between January 2018 and December 2024. The patients were divided into three anastomosis groups: the end-to-side group (54 cases), the FETE group (133 cases), and the Overlap group (70 cases). Intraoperative parameters, postoperative complications, and early postoperative recovery were compared among the three groups.

The basic data of the three groups were not statistically significant. The Overlap group exhibited longer operative time compared to the end-to-side and FETE group, and the FETE group had significantly less intraoperative blood loss than the end-to-side group (P<0.001). No statistically significant differences were observed among the three groups in terms of time to first flatus, postoperative hospital stay, or incidence of complications. The white blood cell counts and neutrophil counts in the end-to-side group were lower than those in the other two groups after the operation (P<0.01).

End-to-side, FETE, and Overlap anastomotic techniques are equally safe and effective for laparoscopic radical right hemicolectomy. The choice of technique shall be individualized based on patient-specific factors and intraoperative conditions.