腹腔镜辅助下结直肠癌切除手术的临床应用.doc

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11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 ~72 h 均恢复胃肠功能, 术后疼痛轻, 无术中大出血、术后无特殊并发症发生。术后住院时间(不包括化疗) 7 ~11(平均9 ) d。随访42例( % ) , 随访时间3 ~60个月, 2 例死亡, 均为Dukes C 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】 【文献标识码】A 【文章编号】2095-1752(2012)18-0372-02
Clinical application of laparoscopic assisted surgery for colorectal cancer
Zhong hong,Shi District People’s Hospital(Shenzhen 518172,China)
【Abstract】 Objective To explore the feasibility and value of laparoscop ic assisted surgery ( LAS ) for colorectal cancer. Methods The clinical data of 51 cases of LAS for colorectal cancer were reviewed retrospectively. Of them , 2 cases were converted to open operation , and in 49 cases LAS for colorectal cancer pleted. Among them , 10 cases underwent right hemicolectomy, 10 cases left
hemicolectomy , 12 cases sigmoid resection , 11 cases rectal anterior resection , and 8 cases Miles operation. Results No intraoperative deaths occurred. The average operation time was 200 ( 150 - 330 ) min with 150 ( 50 - 350 )