摘要
目的:探讨经自然腔道(肛门)取标本三孔法腹腔镜乙状结肠及直肠癌根治术治疗乙状结肠癌、直肠癌的安全性、可行性。方法:2022年2月至2023年4月为10例乙状结肠癌、直肠癌患者行三孔法腹腔镜乙状结肠及直肠癌根治术,经肛门取标本,腹部无辅助切口。结果:10例手术均顺利完成,手术时间平均(275.0±58.1)min,术中出血量平均(28.5±14.9)mL,术后首次肛门排气时间(38.4±11.0)h,进流食时间(2.3±0.7)d,术后平均住院(9.2±1.5)d。1例患者于术后第2天晚上发热38.7℃,予以抗感染治疗,第4天体温恢复正常;均无其他术后并发症发生。术后TNM分期:0~Ⅰ期4例,Ⅱ期2例,Ⅲ期4例。住院总费用平均(35012.99±2458.68)元。术后随访1~14个月,中位随访时间6个月,其中4例术后行辅助化疗;均未发现肿瘤复发、转移。结论:经自然腔道(肛门)取标本三孔法腹腔镜乙状结肠及直肠癌根治术治疗乙状结肠癌、高位直肠癌在技术上安全、可行,近期疗效理想。
Objective:To investigate the safety and feasibility of three-port laparoscopic radical resection of sigmoid colic cancer and rectal cancer with natural orifice(anus)specimen extraction surgery for sigmoid or rectal cancer.Methods:A total of 10 patients with sigmoid or rectal cancer from Feb.2022 to Apr.2023 were treated with three-port laparoscopic radical resection of sigmoid colic cancer and rectal cancer.During the operation,the specimen was taken out through the anus without auxiliary incision in the abdomen.Results:All the operations were successful.The mean operative time was(275.0±58.1)min,the mean intraoperative blood loss was(28.5±14.9)mL,the anus exhaust time after operation was(38.4±11.0)h,the mean time of liquid diet was(2.3±0.7)d,and the mean postoperative hospital stay was(9.2±1.5)d.During the hospitalization,the body temperature in 1 case reached 38.7℃on the second night after operation,and the temperature returned to normal on the fourth day after anti-infective treatment.No postoperative complications occurred in the 10 cases.Postoperative TNM stage were stage 0-Ⅰ(4 cases),stageⅡ(2 cases)and stageⅢ(4 cases).The mean total hospitalization cost was(35012.99±2458.68)yuan.The 10 cases were followed up for 1-14 months,with a median time of 6 months,in which 4 cases received adjuvant chemotherapy after surgery.No tumor recurrence or metastasis occurred.C onclusions:Three-port laparoscopic radical resection of sigmoid colic cancer and rectal cancer with natural orifice(anus)specimen extraction s urgery for sigmoid or upper rectal cancer is safe and feasible,with ideal short-term efficacy.
作者
陈金水
石璐璐
王铁虎
杨松
杨卢琦
尚辉辉
郑开福
李正平
CHEN Jinshui;SHI Lulu;WANG Tiehu(Department of General Surgery,the 991st Hospital of Joint Logistic Support Force of People's Liberation Army,Xiangyang 441003,China)
出处
《腹腔镜外科杂志》
2023年第9期670-674,689,共6页
Journal of Laparoscopic Surgery
基金
2022年第九九一医院科研课题(991YJ-202207)。
关键词
直肠肿瘤
乙状结肠肿瘤
经自然腔道取标本手术
腹腔镜检查
三孔法
Rectal neoplasms
Sigmoid neoplasms
Natural orifice specimen extraction surgery
Laparoscopy
Three-port method
