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1、腹腔镜结直肠癌切除51例临床分析马俊1张家骅2马旭东1唐辉蓉1吴雪松1摘要目的探讨腹腔镜下结直肠癌根治的可行性和临床应用价值。方法对51例结直肠癌腹腔镜下行结直肠癌根治性切除的操作和临床治疗进行回顾性分析和总结。结果51例患者全部完成腹腔镜下根治性切除。平均手术时间3﹒7h,平均出血量70-80ml，平均拔出尿管时间7天，平均术后住院时间11天，术后吻合口瘘4例，2例死亡，2例治愈，阴道会阴瘘1例，经再次手术治愈，肺部感染4例，切口感染3例，无输尿管、膀胱、前列腺、尿道损伤及大出血发生，淋巴结清扫平均7
2、枚，随访3-24个月，复发4例，死亡1例，术口肿瘤种植1例，无肠梗阻病例发生。结论腹腔镜下结直肠癌切除可达根治性切除的效果，而且具有创伤小、恢复快、并发症发生率低的优势，有广阔的临床应用价值。关键词腹腔镜结肠直肠癌手术切除中图分类号：R735.305文献标识码：AClinicalanalysisfor51casesoflaparoscopicoperationofcolorectalcarcinomaMaJunZhangJia-huaMaXu-dongTangHui-rongWuXue-songDepa
3、rtmentofGeneralSurgery,thesecondaffiliatedhospitalofKunMingMedicalCollege,Kunming650101,China.AbstractObjectiveToevaluatethemethodsandtheclinicalvalueoflaparoscopicoperationforcolorectalcarcinomaMethodThe51casesdataoflaparoscopicoperationofcolorectalcarc
4、inomawereanalyedretrospectivelyandsummarized.ResultsThe51casesweretreatmentedbytotallylaparoscopicsurgery.Theaverageoftheoperationtimeis3.7hours,theaverageofinteroperationbloodlossis70-80ml,theaveragetimeofthestomachtuberemovedis7days,thepost-operationho
5、spitalstayis11days.Therewerepost-operationanastomaticleakage4cases,2casedied,2caseswerecured.Therewasperinovaginalfistulaonecase,wascuredinthesecondaryoperation.Therewereinfectionoflung4cases,infectionofincisionwoundoccurred3cases.Noneurethra,bladder,pro
6、statehurtandmassivehaemorrhage.Therewereaverage7lymphnodeswereeliminated.Thefollow-upperiodwas3-24months.Therewere4casesrecurrence,onedied.Incisionimplantiononecase.Noneileus.ConclusionThelaparoscopicoperationofcolorectalcarcinomaisnotonlycouldcutoffthec
7、arcinomaradically,butalsohastheadvantageofmini-invasion,quickrecovery,lowerrateofpostoperationcomplications.Ithaslargeworthyofclinical.Keywordlaparoscopycolorectalcarcinomasurgery1991年Jacobs(1)报道了第一例腹腔镜结肠切除，使结肠切除手术方式发生了一个根本性变化，1993年郑民华在我国率先开展了腹腔镜结直肠癌切除术(
8、2)，以后该手术方式在我国逐渐推广，其优势也日见显现，目前进入了提高总结的阶段，现将我科2008年10月---2010年10月间开展的51例结直肠癌腹腔镜下手术切除治疗体会作以下总结报道。1.临床资料和方法1.1临床资料本组病例中男28例，女23例，年龄24—85岁，平均65.4岁，所有病例术前全部经纤维结肠镜检查和取材病理检查证实为：恶性肿瘤，并行双肺和全腹CT平扫明确肿瘤与周围器官关系及是否有淋巴结和远隔器官转移。1.2手术方式1.2.
