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1、腹腔镜辅助下结直肠癌切除手术的临床应用钟宏史勇（深圳市龙岗区人民医院普外科广东深圳518172）【摘要】目的探讨腹腔镜辅助下结直肠癌切除手术的可行性和应用价值。方法回顾性分析51例腹腔镜结直肠癌切除手术的临床资料。腹腔镜下完成结直肠手术49例，中转开腹2例。其中右半结肠切除术10例，左半结肠切除术10例，乙状结肠切除术12例，直肠前切除术门例，腹会阴联合根治术8例。结果全组无手术死亡。腹腔镜手术时间150〜330（平均200）min,术中出血50〜350（平均150）mL,手术清除淋巴结1〜25（平均7）枚。术后24〜72h均恢复胃肠功能，术后
2、疼痛轻，无术中大出血、术后无特殊并发症发生。术后住院时间（不包扌舌化疗）7〜11（平均9）d。随访42例（82.4%）,随访时间3〜60个月，2例死亡,均为DukesC期直肠癌患者,1例术后15个月死于肝转移，另1例术后18个月死于腹腔广泛转移并衰竭。未发现套管穿刺部位及辅助小切口处肿瘤种植和局部复发。结论腹腔镜结直肠癌手术在应用技术上可行，且具有创伤小、痛苦少、恢复快等特点，是治疗结直肠癌的一种微创、安全而有效的术式。【关键词】结直肠肿瘤外科学腹腔镜术【中图分类号】R730.56【文献标识码】A【文章编号】2095-1752（2012）18-
3、0372-02ClinicalapplicationoflaparoscopicassistedsurgeryforcolorectalcancerZhonghong,ShiYong.LonggangDistrictPeople’sHospital（Shenzhen518172,China）【Abstract】ObjectiveToexplorethefeasibilityandvalueoflaparoscopicassistedsurgery（LAS）forcolorectalcancer.MethodsTheclinicald
4、ataof51casesofLASforcolorectalcancerwerereviewedretrospectively.Ofthem,2caseswereconvertedtoopenoperation,andin49casesLASforcolorectalcancerwascompleted.Amongthem,10casesunderwentrighthemicolectomy,10caseslefthemicolectomy,12casessigmoidresection,11casesrectalanteriorresecti
5、on,and8casesMilesoperation.ResultsNointraoperativedeathsoccurred.Theaverageoperationtimewas200(150・330)minwith150(50・350)mLaveragebloodloss.Theaveragenumberoflymphnodesexcisedwas7(1-25).Thetimeofbowelfunctionrecoverywas24-72hafteroperation.Theaveragehospitalstayafteroperatio
6、nwas9(7・12)d.Nomajorintraoperativebloodlossnorpostoperativecomplicationswereobserved.Thefollowuptimewasfrom3–60monthsfor42(82.4%)patients.TwocaseswithDucke’sCrectalcancerdied,onediedoflivermetastasis15monthsafteroperation,andtheanotherdiedofdiffuseperitonealmetas
7、tasis18monthsafteroperation.Therewasnotrocarporttumormetastasisandnolocaltumorrecurreneeatthesmallabdominalincision.ConclusionsLASofcolorectalcanceristechnicallyfeasibleandhasadvantagessuchaslesssurgicaltraumaJessbleedingandquickrecovery.Itisaminiinvasive,safeandefficienttre
8、atmentforcolorectalcancer.【Keywords]ColorectalcarcinomasurgeryLaparoscopy自1
