关键词: 腹腔镜； 左半结肠切除, 结肠癌； 完整结肠系膜切除

Abstract: Objective To summarize the methods and key points of laparoscopic assisted colon splenic flexure free.
Methods 21 cases of colon cancer with splenic flexure or proximal splenic flexure were treated by laparoscopy.The gastrocolic ligament was cut off under the gastroepiploic vascular arch,and the root of transverse mesocolon was cut off at the lower edge of pancreas.The corresponding vessels were ligated and the lymph nodes of No253 and No223 were removed.Through the small incision in the left upper abdomen,the resection was performed outside the abdominal cavity,and the end-to-end anastomosis was performed.
Results 20 patient were successfully performed under laparoscopy.One patient was converted to laparotomy when part of the gastric wall was resected because the tumor invaded the greater curvature of the stomach.The average time of laparoscopy was(65.4 ± 6.1)min.The average number of lymph nodes was(20.6 ± 3.1).The average blood loss was(30.7 ± 6.2)ml.The average length of auxiliary incision was(8.5 ± 1.5)cm.,and the postoperative hospital stay was(6.8 ± 0.9)d.No other incision or puncture site complications,intestinal fistula and abdominal infection occurred.
Conclusion Standardized laparoscopic is a safe and effective treatment for the colon splenic flexure dissociation The prospective study of D3 dissection can achieve safe results. 

Key words: laparoscopy, resection of the left colon, colon carcinoma, complete mesocolic excision