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1、腹腔镜全冇肠系膜切除保肛治疗冇肠癌的临床应用［摘要］目的：探讨腹腔镜真肠癌全Sf•肠系膜切除(laparoscopictotalmesorectalexcision,LTME)保肛术的可行性、安全性、操作要点及治疗效果。方法：冋顾分析39例腹腔镜直肠全系膜切除术患者的临床资料。结果：39例患者手术顺利，无中转开腹，手术时间为］40〜280min,平均150min；术中出血20〜130ml,平均40ml；淋巴结清扫4〜23枚,平均10.3枚。术后30〜72h恢复胃肠功能并下床活动，住院时间5〜16d,平均9d。39例术后随访2〜36个月，平均18个月，均未发
2、现吻合口肿瘤复发及远处转移。结论：腹腔镜全直肠系膜切除保肛治疗頁肠癌，除具有创伤小、出血少、保肛率高、术后疼痛轻、恢复快等优点外，对白主神经丛的保护更准确，术后肛门括约肌功能及排尿功能良好，是一项微创治疗肓肠癌的技术。［关键词］直肠肿瘤；腹腔镜；全直肠系膜切除术；保肛术［中图分类号］R735.3+7［文献标识码］A［文章编号］1674-4721(2011)08(b)-054-03Clinicalapplicationoflaparoscopictotalmesorectaiexcisionandanalsphincterpreservationinthet
3、reatmentforrectalcancerZHENGZhengl,NIEWanpin21・HunanProvinceChestHospital,HunanProvince,Changsha410081,China;2.ThirdXiangyaHospitalofCentralSouthUniversity,HurmnProvince,Changsha410013,China［Abstract］Objective:Toexplorethefeasibi1ity,safety,operatingessentialsandtherapeuticeffecto
4、flaparoscopictotalmesorectalexcisionwithanalsphincterpreservationinthetreatmentforrectalcancer.Methods:Theclinicaldataof39caseswithlaparoscopictotalmesorectalexcisionwereanalyzedretrospectively.Results:39casesweresuccessfullycompletedandnoneofthepalientswereconvertedtoopensurgery.
5、Theoperationtimewas140-280min,theaverageof150min,andtheintraoperativebloodlosswas20-120ml,theaverageof40ml.4-23lymphnodeswereresected,theaverageof10・3lymph.Thepostoperativeconvalesceneeofintestinalperistalsiswas30-72hours,theaverageof48hours・Thepostoperativehospitalstaywas5T6clays
6、,withanaverageof9days・Allthesecondtirydamagesweremanagedsuccessfullywith1aparoscopy.Nocomplicationsofanastomoticleakageoccurredaftertheoperation.Conclusion:Laparoscopictotalmesorectalexcisionandanalsphincterpreservationinthetreatmentforrectalcancerisaperspectiveminimallyinvasivete
7、chnique,whichisfeasible,safeandeffective.Withtheuseofthistechnique,surgeonscouldaccomplishhigherratesofsphincterpreservation,moreaccurateautonomicnervepreservationandgoodmicturationwithdecreasedpostoperativepainandrapidrecovery-［Keywords］Rectalcancer;Laparoscope;Totalmesorectalexc
8、ision;Analsphincterpreservation胃肠
