摘要
目的初步探讨腹腔镜辅助经肛门全直肠系膜切除术在中低位直肠癌临床应用的安全性和近期疗效。方法回顾分析2017年9月1日至2019年12月31日我院收治的21例实施了腹腔镜辅助经肛门全直肠系膜切除术的中低位直肠癌患者的临床资料。结果全部21例患者均行了腹腔镜辅助经肛门全直肠系膜切除术,其中男16例,女5例,平均(62.81±12.66)岁,平均BMI (23.89±2.70) kg/m2,行了术前新辅助治疗9例。手术时间平均(178.62±63.75) min,术中出血量平均(50.48±18.57) ml,11例(52. 4%)患者行了末端回肠预防性造口。切除标本肿瘤下缘距切缘(2.16±0.51) cm,术后病理下切缘和环周切缘均为阴性,平均淋巴结检测数目为(15.95±4.46)枚。术后1例患者出现轻症吻合口漏,保守治疗好转;术后住院天数平均为(10.62±5.60)d,所有患者均顺利出院。术后随访3个月-2年,除1例因发生多发肝转移于术后12个月死亡,其余均无复发转移。结论腹腔镜辅助经肛门全直肠系膜切除术能达到直肠癌根治效果,且具有创伤小、术后恢复快的优点,是中低位直肠癌手术患者安全、可靠的选择。
Objective To evaluate the safety and short-term efficacy of laparoscopic-assisted transanal total mesorectal excision(TME) for middle and low rectal cancer. Methods The clinical data of 21 patients with mid-low rectal cancer who underwent laparoscopic-assisted transrectal total mesorectal excision were analyzed retrospectively from September 1,2017 to December 31,2019. Results All 21 patients were successfully underwent laparoscopic-assisted transanal total mesorectal excision, including 16 males and 5 females, with an average age of(62.81±12.66) years old and the average BMI was(23.89±2.70) kg/m2. 9 patients were underwent preoperative neoadjuvant therapy. The average operative time was(178.62±63.75) mins and the average intraoperative bleeding volume was(50.48±18.57) ml, and terminal ileostomy was performed in 52.4% of the 11 patients. The distance from the lower margin of the tumor was(2.16±0.51) cm, the average number of detected lymph nodes was(15.95±4.46),and The pathological margin of inferior incision and circumferential incision were negative. One patient suffered mild anastomotic leakage after operation, and the average length of hospital stay was( 10.62±5.60)days, all patients were discharged smoothly. During the follow-up period of 3 months to 2 years, there was no recurrence or metastasis except one case with concurrent multiple liver metastasis 5 months after operation. Conclusion TaTME is a safe and reliable choice for patients with middle and low rectal cancer, which has the advantages of less trauma and faster postoperative recovery.
作者
袁喜红
李坚
王俊
华丽
徐晓阳
周凯
YUAN Xihong;LI Jian;WANG Jun(Department of General Surgery,Jiangxi provincial People’s Hospital Affiliated to Nanchang University,Nanchang 330006,China.)
出处
《江西医药》
CAS
2020年第7期797-800,共4页
Jiangxi Medical Journal
基金
江西省卫生健康委科技计划,编号20201013。
