术前肠道支架联合腹腔镜Ⅰ期手术治疗梗阻性左侧大肠癌21例  

Preoperative intestinal stent decompression with primary laparoscopic surgery for treating left-sided colorectal cancer with obstruction:A report of 21 cases

作　　者：郑超[1] 吴育连[1] 李青[2] 

机构地区：[1]浙江大学医学院附属第二医院普外科,杭州市310009 [2]浙江中医药大学附属第一医院胃肠外科

出　　处：《中国肿瘤临床》2013年第7期417-419,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨运用术前肠道支架减压联合腹腔镜手术,在治疗梗阻性左侧大肠癌Ⅰ期切除吻合术中的安全性和有效性。方法:回顾性分析浙江中医药大学附属第一医院胃肠外科于2008年3月至2011年12月梗阻性左侧大肠癌患者21例,术前行结肠镜下肠道支架置入解除肠梗阻,7～10d后行腹腔镜下大肠癌根治性切除术。结果:20例患者腹腔镜手术成功,1例因肿瘤侵犯左侧输尿管而中转开腹;手术时间180～320min,平均220min;术后肠功能恢复时间2～5d,平均3d;1例出现切口感染,无吻合口漏发生。结论:术前肠道支架减压联合腹腔镜Ⅰ期手术是治疗梗阻性左侧大肠癌安全有效的方法。Objective： This work aimed to study the safety and effectiveness of preoperative intestinal stent decompression com-bined with laparoscopic surgery for the treatment of left-sided colorectal cancer with obstruction （LCCO）. Methods： A retrospective analysis of data from 21 LCCO patients admitted to the First Affiliated Hospital of Zhejiang Chinese Medicine University from March 2008 to December 2011 was conducted. Preoperative intestinal stent placement under colonoscopic guidance was performed to remove the intestinal obstruction. About 7 d to 10 d afterwards, laparoscopic radical surgery of the colorectal cancer was carried out. Results：Among the 21 cases studied, laparoscopic surgery was successful in 20 patients. Emergent laparotomy was conducted in 1 patient be-cause of tumor invasion of the ureter. Operation times ranged from 180 min to 320 min, and the average time was 220 min. Recovery times of bowel function ranged from 2 d to 5 d, and the average time was 3 d. Postoperative infection of the incision occurred in 1 case. No anastomotic leakage was seen in any of the cases. Conclusion： Preoperative intestinal stent decompression combined with primary stage laparoscopic surgery is a safe and effective method for treating left-sided obstructive colorectal cancer.

关 键 词：大肠癌 肠梗阻 肠道支架 腹腔镜 

分 类 号：R735.34[医药卫生—肿瘤]