腹腔镜下结直肠癌手术的疗效分析  

Laparoscopic Resection for Colorectal Carcinoma

作　　者：蒋珂[1] 朱湘南[1] 宁国强[1] 袁堂战[1] 郑杨[1] 

机构地区：[1]南昌大学第四附属医院普外科,南昌330002

出　　处：《实用临床医学（江西）》2010年第5期32-34,共3页Practical Clinical Medicine

摘　　要：目的探讨腹腔镜下结直肠癌手术的安全性、有效性、手术方法及其应用价值。方法回顾性分析2006年6月至2009年8月32例结直肠癌患者施行腹腔镜手术的临床资料。结果本组中直肠癌10例,乙状结肠癌12例,降结肠癌和升结肠癌各5例。共28例手术顺利完成,其中施行Dixon手术8例,Miles手术2例,乙状结肠根治性切除10例,乙状结肠部分切除1例,左半结肠切除4例,右半结肠切除3例;4例患者因肥胖或肿瘤侵犯邻近器官而中转开腹手术。术中平均失血量约为110 mL,平均清扫恶性肿瘤淋巴结数目13.5枚,术后肠功能恢复时间平均40 h,平均住院时间9 d。无手术死亡病例,无术后出血、吻合口漏等并发症发生。结论腹腔镜下结直肠癌手术具有创伤小、术后恢复快等优点,只要能严格把握适应证和熟练掌握腹腔镜技术,此术式安全、有效,具较好的应用前景。Objective To investigate the safety,effectiveness and operative method and clinical value of laparoscopic resection for colorectal carcinoma.Methods The clinical data of 32 patients with colorectal carcinoma undergoing laparoscopic resection from Jun.2006 to Aug.2009 were retrospectively reviewed.Results Among 32 cases,there were 10 cases of rectal cancer,12 cases of sigmoid colon carcinoma,5 cases of descending colon carcinoma,5 cases of ascending colon carcinoma.Twenty eight cases were successful performed laparoscopic resection,including 8 Dixon operation,2 Miles operation,10 radical resection of sigmoid colon,1 palliative resection of sigmoid colon,4 left hemi-colectomy and 3 right hemi-colectomy.4 cases were converted to open procedure because of adiposity or advanced status of local disease.The mean intraoperative blood loss was 110 mL,the mean number of lymph nodes harvest was 13.5,the mean recovery time of intestinal function was 40 hours,and the average hospital stay was 9 days.No patient died during operation and no complications such as anastomotic leakage and postoperative hemorrhage occured.Conclusion Laparoscopic resection for colorectal carcinoma is a safe and effective procedure with the advantages of minimal invasion and rapid recovery.The strict mastery of indication and skillful laparoscopic technique are the keys of successful operation.

关 键 词：结直肠癌 腹腔镜 手术 

分 类 号：R735.37[医药卫生—肿瘤]