腔镜下在腹会阴联合直肠切除术在治疗低位直肠癌中的应用  

Application of laparoscopic abdominoperineal resection in the treatment of low rectal cancer

作　　者：杨新辉[1] 赵泽亮[1] 孟涛[1] 赵为民[1] 范川文[1] 王海江[1] 

机构地区：[1]新疆医科大学附属肿瘤医院腹外科,新疆乌鲁木齐830011

出　　处：《新疆医科大学学报》2009年第9期1295-1297,共3页Journal of Xinjiang Medical University

摘　　要：目的:探讨腹腔镜腹会阴联合直肠切除术(laparoscopic abdominoperineal resection,LAPR)治疗低位直肠癌的可行性、安全性、根治性及近期疗效。方法:对16例低位直肠癌患者经腹腔镜实施腹会阴联合切除术的临床资料进行回顾性分析。结果:16例患者中15例均成功完成手术,1例中转开腹。手术时间180～300min,平均260 min,术中出血20～80 ml,平均出血量40 ml。术后住院(不包括化疗时间)7～10 d,平均为8d。术后胃肠功能恢复时间12～36 h,无手术死亡、输尿管损伤、骶前出血、切口感染等并发症。患者术后随访至今5～16个月,无复发转移情况。结论:腹腔镜下腹会阴联合切除术治疗低位直肠癌已成为安全可行的手术方式,并具有出血少、恢复快、住院时间短等优点。Objective： To assess the feasibility , safety,radical cure and short-outcome of laparoscopic abdominoperineal resection （LAPR） in the treatment of low rectal cancer. Methods： The clinical data of 16 cases with low rectal cancer undergone LAPR with laparoscopic total mesorectal excision （TME） were analyzed retrospectively. Results： One case was converted to open surgery. The operations in 15 cases were performed well. The mean duration of operations was 260 rain （range 180-300 min）. The amount of bleeding was 40 ml （range 20-80 ml）. The gastrointestinal function recovered in 12-36 h after opera tion. There were no operative deaths, ureteral injury, antero-sacrum vascular plexus bleeding and incision infections. The length of hospital stay was 8 d （range 7410 d）. All patients were followed up for 5-16 months after operation. No metastasis and recurrence occurred. Conclusion： LAPR for low rectal cancer with TME is feasible and effective. LAPR has the benefits of less bleeding, faster recovery and shorter hospital stay.

关 键 词：直肠癌 腹腔镜会阴联合直肠切除术 全直肠系膜切除 

分 类 号：R616.2[医药卫生—外科学] R735.37[医药卫生—临床医学]