摘要
目的:探讨腹腔镜辅助经肛全直肠系膜切除术(laparoscopic-assisted transanal total mesorectal excision,La-TaTME)治疗中低位直肠癌的安全性及近期疗效。方法:回顾性分析南华大学附属第一医院胃肠外科2017年12月至2018年6月施行La-TaTME术的15例中低位直肠癌患者的临床资料。结果:15例患者中,男性10例,女性5例,年龄为(52.7±6.4)岁,体质量指数为(24.8±2.1)kg/m^2。15例患者均顺利完成手术,无一例中转开腹;手术时间为(293.5±72.4)min,术中出血量为(91.8±24.6)mL;术后造口排气时间为(1.8±0.6)d,术后下床活动时间为(1.5±0.3)d,术后引流管拔除时间为(7.8±3.4)d,术后住院天数为(13.0±1.8)d;术后出现肛周感染1例,吻合口瘘2例,予以冲洗引流、抗感染、肛门坐浴等保守治疗后恢复;中位随访6个月未见肿瘤复发转移,无死亡病例。结论:对于中低位直肠癌患者,La-TaTME手术是安全可行的,近期疗效较好。
Objective:To explore the safety,feasibility and short-term outcomes of laparoscopic-assisted transanal total mesorectal excision(La-TaTME)for middle-low rectal cancer.Methods:This retrospective research collected and analyzed the clinical data of 15 patients diagnosed with middle or low rectal carcinoma who underwent La-TaTME from December 2017 to June 2018 in the Department of Gastrointestinal Surgery,the First Affiliated Hospital of University of South China.Sequential La-TaTME was applied to patients by the same operation team.Results:Among 15 patients with rectal cancer,there were 10 males and 5 females with the average age of(52.7±6.4)years old and the average body mass index of(24.8±2.1)kg/m 2.All 15 patients successfully underwent La-TaTME and no case was converted to laparotomy.In none of the enrolled cases was the circumferential resection margin test positive by histopathology examination.Besides,there was no residual tumor detected at the proximal and distal resection margins.The average operating time was(293.5±72.4)min and the average blood loss was(91.8±24.6)mL.The first exhaust time and the first ambulation time after the operation were at(1.8±0.6)d and(1.5±0.3)day,respectively.Drainage tubes were removed(7.8±3.4)d after the surgery,with the post-operative hospital stay being(13.0±1.8)d.Post-operative perianal infection occurred in 1 case and another 2 patients suffering from anastomotic fistula.However,these complications did not result in serious consequences because of the pelvic drainage tube and defunctioning stoma for each patient.These 3 patients were recovered with washing and drainage,antibiotic therapy,anus sitz bath and other symptomatic and supportive treatments.No postoperative abdominal wound infection,abdominal bleeding,intestinal blockage,lung infection and other obvious complications was observed.During a median follow-up period of 6 months,no local recurrence or metastasis was observed and there was no death.Conclusion:La-TaTME is a safe and feasible alternative to standar
作者
陈浪
龙飞
周新栋
邓江平
欧阳军
赵晓春
CHEN Lang;LONG Fei;ZHOU Xindong;DENG Jiangping;OUYANG Jun;ZHAO Xiaochun(Department of Gastrointestinal Surgery,the First Affiliated Hospital of University of South China,Hunan Hengyang 421001,China;Department of Gastrointestinal Surgery,the Third Xiangya Hospital of Central South University,Hunan Changsha 410013,China)
出处
《现代肿瘤医学》
CAS
2020年第24期4304-4308,共5页
Journal of Modern Oncology
基金
湖南省临床医疗技术创新引导项目(编号:2018SK51609)。
