高频电铲在腹腔镜直肠癌保肛手术中的临床应用  

Standard electrosurgical shovel in laparoscopic operation for rec- tal cancer patients with anal sphincter preservation

作　　者：周保军[1] 宋伟庆[1] 闫庆辉[1] 蔡建辉[1] 任鹏涛[1] 林林[1] 李冬斌[1] 赵晶[1] 范占彬[1] 

机构地区：[1]河北医科大学第二医院胃肠外科,石家庄050000

出　　处：《国际外科学杂志》2007年第11期727-729,共3页International Journal of Surgery

摘　　要：目的评价腹腔镜直肠癌保肛手术中应用高频电铲的可行性和安全性。方法选取2005年3月至2007年5月间使用高频电铲成功进行腹腔镜保肛手术的直肠癌患者28例，分别对患者术中出血量、手术时间、术后盆腔引流量、肛门排气时间、疼痛程度以及手术并发症等指标进行观察和记录。结果手术时间（178．6±25．3）min、术中出血量（62．6±40．5）ml、术后盆腔引流量：术后1d（90．5±27．1）ml、术后3d（5．4±4．6）ml、肛门排气时间（33．0±5．4）h、疼痛程度（VAS）：术后1d（5．52±1．29）、术后3d（2．42±1．06）、吻合口瘘1例、切口感染1例。随访1～26月无肿瘤复发及肠梗阻患者。结论高频电铲是一种非常实用的工具，应用于腹腔镜直肠癌保肛手术是安全可行的，并可以降低医疗费用。Objective To assess the feasibility and safety of the standard electrosurgical shovel in laparoscopic operation for rectal cancer patients with anal sphincter preservation. Methods Twenty-eight rectal cancer patients were performed laparoscopic radical operation with anal sphincter preservation using the standard electrosurgical shovel from March 2005 to May 2007. The operative time, blood loss, pelvic volume of drainage, anal exhaust time, visual analogue scales （VAS） and complications were recorded. Results The operative time was （ 178.6 ±25.3 ） min, blood loss （ 62.6 ± 40.5 ） ml, pelvic volume of drainage 1 day post operation（ 90.5 ± 27.1 ）ml and 3 days post operation（5.4 ± 4.6）ml, anal exhaust time（33.0 ± 5.4）h, VAS 1 day post operation （5.52± 1.29） and 3 days post operation（2.42 ± 1.06）, anastomotic leakage and infection of incision were found in one case respectively. During 1 and 26 months follow-up, no recrudescent and ileus patients were found. Conclusions The standard electrosurgical shovel is a useful, feasible and safe tool for rectal cancer patients with anal sphincter preservation in laparoscopic radical operation, which can reduce the medical cost for rectal cancer patients.

关 键 词：腹腔镜手术 电外科 直肠癌 

分 类 号：R735[医药卫生—肿瘤]