腹腔镜结直肠癌根治术85例临床分析  

Clinical analysis on laparoscopic radical resection of colorectal cancer in 85 cases

作　　者：孙虎[1] 朱建国[2] 

机构地区：[1]淮安市第一人民医院一分院普外科,江苏淮安223002 [2]淮安市第一人民医院,江苏淮安223002

出　　处：《现代医药卫生》2011年第23期3551-3552,共2页Journal of Modern Medicine & Health

摘　　要：目的：探讨腹腔镜结直肠癌根治术的临床应用疗效和可行性。方法：回顾性分析近2年85例腹腔镜结直肠癌根治术的临床资料,其中行右半结肠切除术8例,横结肠切除术4例,左半结肠切除术10例,乙状结肠切除术11例,结肠次全切除术2例,直肠癌行Dixon术26例,Miles术20例,中转开腹4例。结果：81例顺利完成手术,1例直肠中动脉出血、3例晚期肿瘤侵犯周围脏器中转开腹。手术平均时间190 min,术中平均出血量110 mL,术后平均住院时间9 d。81例患者术后随访时间1~18（平均9）个月。1例Dixon术后8个月发现肝转移,1例Miles术后14个月发生会阴部转移。腹壁Trocar穿刺部位及小切口部位未发现肿瘤转移。结论：腹腔镜下进行结直肠癌根治术,具有操作安全、创伤小、恢复快等优点,不仅技术上可行,而且完全可达到与开腹根治术相同的效果。Objective：To explore the therapeutic effect and feasibility of laparoscopic-assisted radical excision of colorectal cancer.Methods：The clinical data in 85 cases of colorectal cancer performed laparoscopic colorectomy in our department from October 2008 to October 2010 were analyzed retrospectively,including 8 cases of right hemicolorectomy,4 cases of transverse colorectomy,10 cases of left hemicolorectomy,11 cases of sigmoid colorectomy,2 cases of subtotal colorectomy,26 cases of Dixon operation and 20 cases of Miles operation.4 cases were converted to open colorectomy.Results：81 cases were performed operation successfully.1 case of middle rectal arterial hemorrhage and 3 cases of peripheral visceral infiltration of advanced cancer were converted to laparotomy.The mean operation time was 190 min.The mean intraoperative bleeding volume was 110mL.The mean length of stay after operation was 9 d.In laparoscopic surgery group,81 cases were followed up for 1 month to 18 months（mean 9 months）.1 case of Dixon operation was found hepatic metastasis after 8 months and 1 case of Miles operation was found perineal metastasis after 14 months.No metastasis was found in the site of paracentesis and incisal opening.Conclusion：The laparoscopic radical operation of colorectal cancer is not only technologically feasible and safe with less trauma,less pain and rapid recovery,but completely obtains the same effect of open colorectomy.

关 键 词：腹腔镜 结直肠癌 根治术 

分 类 号：R5[医药卫生—内科学]