免腹部辅助切口全腹腔镜下直肠癌根治术的临床应用.pdf

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1、海南医学2014年9Y]第25卷第18期HainanMedJ，Sep．2014，Vo1．25，No．18doi：lO．3969／j．issn．1003—6350．2014．18．1051·论著·免腹部辅助切口全腹腔镜下直肠癌根治术的临床应用邹科见，蔡国豪，周卫平，黄平，方壮伟，李仁峰(海南省人民医院胃肠外科，海南海口570311)【摘要】目的探讨免腹部辅助切口全腹腔镜下直肠癌根治手术操作要点、可行性、安全性和近期疗效。方法回顾性分析42例患者行免腹部辅助切口全腹腔镜下直肠癌根治术的临床资料。结果42例患者均顺利完成手术，无中转其

2、他术式，无严重术后并发症，无手术相关死亡。手术时间平均(160-3：35)min，术中出血量平均(80+35．5)ml，手术标本清扫淋巴结平均(12~4．5)枚，术后排气时间(2．0~1．2)d，术后住院时间(13．52~5．06)d，术后发生吻合口漏l例，经保守半个月治疗后治愈。随访l～24个月未见肿瘤局部复发及转移。结论免腹部辅助切口全腹腔镜下直肠癌根治术安全可行，同时具有腹部伤口微创化、术后并发症少和术后恢复快的特点。【关键词】免腹部辅助切口；腹腔镜；直肠癌【中图分类号】R735．37【文献标识码】A【文章编号】1003-

3、6350(2014)18—2678一o3Cfinicalresearchoftotallaparoscopieresectionforrectalcancerwithoutabdominalassistantincision．Z0Uke-fian,CAIguo-hao,ZHOUWei-ping,日ⅣcPiⅣGZhuang一el_JRenDepartmentsofGastrointestinalSurgery,PeopleHospitalofHa~nanProvince，Haikou570311，Hainan,CHINA【Abst

4、ract】ObjectiveToinvestigatethefeasibility,safety,operatingessentialsandtheshort—termtherapeu-tieefectoftotaI】aparoscopicresectionforrectalcancerwithoutabdomina1assistantincision．MethodsClinicalda-tafrom42patientswithrectalcancerfromwereretrospectivelyanalyzed．Results

5、Al】Ofthe42patientswithrectalcancerSuccessfullyreceivedtotallaparoscopieresectionwithoutabdominalassistantincisionorconversiontoothersurgery．Noneofpatientshadseriouspostoperativecomplicationsanddeathrelatedtotheoperation．Theaverageop·cratingtimewas(160~35)minutes．Theb

6、loodlosswas(80~35．5)m1．Thenumberoflymphnodesharvestedwas(12士4．5)andthetimeoffirstbowelmovementwas(2．O士1．2)days．Thepostoperativehospitalizationstaywasn3．523：5．06)days．Therewasonecaseofanastomoticleakageandwascuredbyconservativetreatmentforfifteendays．Nolocalrecol-renc

7、eandmetastasisinpatientswithcolorectalcancerwasfoundafterfollow—upfor24months．ConclusionT0talIaparoscopicresectionforrectalcancerwithoutabdomina1assistantincisioniSsafeandfeasible．withminimallyinvasiveabdominalwoundandfewpostoperativecomplications．【Keywords】Withoutab

8、dominalassistantincision；Laparoscopy；Rectalcancer腹腔镜以其创伤小、全身反应轻、痛苦小、术后脏距离<5ClTI者35例，I>5ClTI者l7例；肿瘤侵犯肠管范器功能恢复快等优势深受外科医师和患者的欢迎。围≥1／2周