Objective To investigate the influence of non-closing mesenteric defect after laparoscopic right colectomy on postoperative internal hernia and bowel obstruction. Methods We retrospectively analyzed the clinical data of 169 patients who received laparoscopic right colectomy in our department during October 1994 to September 2010. Results The median follow-up of these patients was 29 months (2 - 192 months). In the patients, 15 had bowel obstruction (8. 9% ) , 12 of them were cured by conservative treatment, and the other 3 received a second surgery; one of these 3 patients developed bowel necrosis on day 26 postoperation because of internal hernia at the mesenteric defect (the rate of internal hernia was 0. 6% ) ; the other two cases of bowl obstruction were caused by intestinal adhesion. The rate of early postoperative bowel obstruction (within 30 days) was 5. 9% (10/169), and intestinal adhesion accounted for 73. 3% (11/15) of the causes to postoperative bowel obstruction. Conclusions Adhesion is the main reason of postoperative bowel obstruction after non-closing mesenteric defect after laparoscopic right colectomy, and the rate of internal hernia after such procedure is not high.%目的 探讨腹腔镜右半结肠切除术中不关闭系膜裂孔对术后内疝和肠梗阻发生的影响. 方法 回顾性分析北京大学第三医院普外科1994年10月～ 2010年9月169例腹腔镜右半结肠切除术后肠梗阻及内疝的发生情况. 结果 169例随访时间中位数29个月(2 ～192个月),15例(8.9％)发生肠梗阻,12例保守治疗缓解,3例再次手术,其中1例为经系膜裂孔内疝导致肠坏死,发生于术后26 d,内疝发生率为0.6％ (1/169),2例为粘连导致肠梗阻.术后早期肠梗阻(术后30 d内)发生率为5.9％(10/169).粘连占引起术后肠梗阻原因的73.3％(11/15). 结论 腹腔镜右半结肠切除术中不关闭系膜裂孔肠梗阻以粘连型为主,内疝发生率不高.
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