摘要
目的：探讨腹腔镜辅助结直肠癌根治术的可行性、安全性及近期疗效。方法：回顾分析2007年8月至2009年6月施行的32例腹腔镜辅助结直肠癌根治术的临床资料。其中右半结肠切除术5例,横结肠切除术1例,左半结肠切除术7例,乙状结肠切除术5例,结肠次全切除术1例,直肠癌行Dixon手术7例,Miles手术6例。结果：除2例中转开腹外,余30例均在腹腔镜辅助下顺利完成手术,无手术死亡病例;结肠癌切除包括肿块在内的12~23cm肠管;直肠癌行Dixon术或Miles术时,下端切缘距肿瘤下缘3~5cm,术后病理证实所有标本残端均无肿瘤细胞残留、浸润。手术时间130~248min,平均152min;术中出血90~320ml,平均160ml;术后肠蠕动恢复时间36~72h,平均48h;淋巴结清扫4~22枚,平均12.6枚。术后无出血、吻合口瘘和狭窄等并发症发生,术后仅1例切口感染,2个月后再次清创缝合后痊愈;术后住院5~9d,平均7.2d;术后电话随访至2010年2月,死亡1例,局部复发1例,余患者随访期内均未发现转移、复发及切口种植。结论：腹腔镜辅助结直肠癌手术具有患者创伤小、操作安全、术后康复快等优点,不仅技术上可行,而且完全可取得与传统开腹手术同样的治疗效果。
Objective：To explore the feasibility,safety and the short-term outcome of the laparoscopic-assisted radical operation of colorectal cancer.Methods：The clinical data of 32 patients with colorectal cancer performed laparoscopic colorectomy from Aug.2007 to Jun.2009 in our department were analyzed retrospectively,among them,5 cases performed right hemicolectomy,1 case by transverse colorectomy,7 cases by left hemicolorectomy,5 cases by sigmoid colorectomy,1 case by subtotal colorectomy,7 cases by rectal anterior resection and 6 cases by Miles operation.Results：The laparoscopic-assisted radical operation was performed on 30 cases successfully,and 2 cases converted to laparotomy.No one died during operation.Colon cancer was resected including tumors and about 12-23cm intestine.Rectal cancer underwent Miles or Dixon surgery,the bottom incision margin from the inferior border of tumor was 3-5cm.Postoperative pathological examination revealed no residual or infiltration of tumor cells in stump.The operation time was 130-248min（mean,152min）,and the intraoperative blood loss was 90-320ml（mean,160ml）.The postoperative convalescence of intestinal peristalsis was 36-72 hours（mean,48 hours）.4-22 lymph nodes were resected（mean,12.6）.There were no operative complications such as hemorrhage,anastomotic leakage and stenosis.Infection of incision wound occurred in only 1 case,and was cured by debridement 2 months later.The post-operative hospital stay was 5-9 days,with an average of 7.2 days.After surgery,telephone followed up to Feb.2010,one died and one had local recurrence.And other patients in the follow-up period,no metastasis,recurrence or incision implantation were found.Conclusions：The laparoscopic-assisted radical operation of colorectal cancer is not only technologically feasible and safe with less trauma,pain and rapid recovery,but also completely effective comparing to the open colorectomy.
出处
《腹腔镜外科杂志》
2010年第9期672-675,共4页
Journal of Laparoscopic Surgery
基金
全军医学科学技术研究"十一五"计划课题项目(编号:06MA082)
