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作 者:王红军[1]
机构地区:[1]西安交通大学医学院第一附属医院普外科,西安710061
出 处:《山西医科大学学报》2011年第10期842-844,共3页Journal of Shanxi Medical University
摘 要:目的总结和介绍高频电刀在中、低位直肠癌全系膜根治性切除术(total mesorectal excision,TME)中的临床效果及使用技巧。方法回顾性分析西安交通大学医学院第一附属医院2005-01~2008-06间,连续采用美国威力Ⅱ型高频电刀行中低位直肠癌根治术(TME)219例患者的临床资料。结果本组资料清扫淋巴结数量(31.5±9.5)个,与NCCN直肠癌手术的12枚淋巴结标准相比淋巴结清除数增加;手术时间(90.5±15.0)min;术中出血(60±15)ml,手术视野清晰。166例前切除(anterior resection,AR)、低位保肛手术(low anterior resection,LAR),术后无吻合口漏及出血发生;53例腹会阴切除(ab-dominoperineal resection,APR),无术后会阴部切口感染发生。全组患者术后无盆腔出血、淋巴漏及围手术期手术死亡。结论中低位直肠癌根治术中采用高频电刀技术提高了淋巴结清扫的彻底性,高频电刀环周热灼、热辐射作用降低了手术创面癌残留机会,确保了直肠癌根治的效果。Objective To summarize and introduce the clinical efficacy and surgical skills of high-frequency electroscapel in total mesorectal excision(TME) of the middle and lower rectal cancer. Methods Valley Ⅱ high-frequency electroscapel was used to treat 219 patients with low rectal cancer from January 2005 to June 2008 in First Affiliated Hospital of Medical College,Xi'an Jiaotong University.The clinical data of 219 patients were retrospectively analyzed. Results The average number of removed lymph node was 31.5±9.5 for 219 patients with low rectal cancer,higher than the traditional standard of NCCN surgery of 12 lymph nodes.The mean operative time was(90.5 ± 15.0)min,and the operative bleeding volume was(60 ± 15)ml.The surgery vision was clear.Of 166 cases of anterior resection or low anterior resection,no postoperative anastomotic leakage and bleeding occurred.Of 53 cases of abdominoperineal resection,no postoperative perineal incision infection happened.All patients had no pelvic bleeding,lymph leakage and perioperative surgical mortality. Conclusion The high frequency electroscapel could improve the tumor-free surgical margin of lymph adenectomy.It is safe in curative proctectomy for patients with rectal carcinoma.
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