腹腔镜超低位直肠癌保肛手术的临床应用  

Clinical application of laparoscopic anus-preserving operation for lower rectal cancer

作　　者：于仁[1] 葛恒发[1] 陶国全[1] 朱晋国[1] 姜宝飞[1] 

机构地区：[1]南京医科大学附属淮安第一医院,江苏淮安223300

出　　处：《腹腔镜外科杂志》2010年第10期754-756,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨凯途(Contour)在腹腔镜经耻骨上横形小切口超低位直肠癌保肛手术中的应用价值。方法:回顾分析2009年8至2010年2月为8例患者施行腹腔镜超低位直肠癌保肛手术的临床资料。骨盆狭小、超低位直肠癌、肿瘤较大、腹腔镜下直线切割缝合器难以满意闭合的患者,取耻骨上横行小切口置入凯途,直视下行肿瘤远端肠管切割、闭合。结果:8例手术均获成功,残端闭合满意,术中快速冰冻切片未见肿瘤残留,术后无一例发生吻合口瘘。结论:骨盆狭小的患者在腹腔镜超低位直肠癌保肛手术中取耻骨上横行小切口置入凯途直视下行肿瘤远端肠管切割、闭合,操作较直线切割缝合器简单、易行、可靠、经济,具有一定的临床应用价值,值得推广。Objective：To explore the application value of Contour in laparoscopic anus-preserving operation for lower rectal cancer through the small traverse incision above pubic bone.Methods：Eight patients with narrow pelvis,extremely low and large rectal cancer which could not be satisfactorily closed by laparoscopic sharp cutter underwent laparoscopic anus-preserving operation for lower rectal cancer from Aug.2009 to Feb.2010.Their clinical data was retrospectively analyzed.Distal bowel of tumor was incised and closed by Contour under direct view through small traverse incision above pubic bone.Results：Eight operations were all successful,the closures of stump were satisfied,no cancer residual was found by quick pathology.No anastomotic leakage happened after operation.Conclusions：For patients with narrow pelvis,it is simple,feasible,dependent and economic for Contour inserting through small traverse incision above pubic bone to incise and close bowel distal of tumor in laparoscopic anus-preserving surgery for lower rectal cancer.It is valuable to clinical application and should be generalized.

关 键 词：直肠肿瘤 腹腔镜检查 保肛手术 

分 类 号：R735.37[医药卫生—肿瘤]