腹腔镜下结直肠癌及肝转移癌一期同时切除术的临床应用  

Simultaneous laparoscopic resection of colorectal carcinoma and synchronous liver metastasis

作　　者：张红卫[1] 罗旋[1] 曹君[1] 褚忠华[2] 陈洁盈[1] 陈亚进[1] 

机构地区：[1]中山大学孙逸仙纪念医院肝胆外科,广州510120 [2]中山大学孙逸仙纪念医院胃肠外科,广州510120

出　　处：《中华胃肠外科杂志》2014年第8期813-815,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的：探讨腹腔镜下一期同时切除结直肠癌和肝转移癌的安全性及可行性。方法回顾性分析2011年1月至2013年10月期间在中山大学孙逸仙纪念医院完成的腹腔镜下结直肠癌和肝转移癌一期同时切除手术的11例患者的病例资料，对该术式的可行性（中转开腹率、手术时间及术中出血量）、安全性（术后并发症）及疗效（术后恢复、复发及生存情况）进行评估。结果全组11例患者手术均取得成功，无中转开腹病例。手术时间（284．6±28．8） min，术中出血量（322．7±75．4） ml，术后肛门排气时间（2．9±0．7） d，术后住院时间（12．3±1．9） d。全组患者术后未出现肠瘘、胆瘘、腹腔大出血、腹腔感染及肝功能衰竭等并发症。术后随访时间3～35月，除1例患者因肿瘤转移死亡外，其余病例未见肿瘤复发。结论对于经过选择的合适病例，腹腔镜下同时切除结直肠癌和肝转移癌是安全、可行的。Objective To investigate the safety and feasibility of simultaneous laparoscopic resection of colorectal carcinoma and synchronous liver metastasis. Methods Clinical data of 11 patients undergoing simultaneous laparoscopic resection of colorectal carcinoma and synchronous liver metastasis in our hospital from January 2011 to October 2013 were reviewed retrospectively. Feasibility , safety and efficacy of this procedure were investigated. Results Procedure was completely successful in all the cases without conversion. The mean operation time was （284.6±28.8） min and the mean blood loss was （322.7±75.4） ml. The mean time to intestinal function recovery was （2.9±0.7） d and the mean hospital stay was （12.3 ±1.9） d. There were no anastomosis leakage, bile leakage, abdominal massive bleeding or infection, and liver failure after operation. During follow-up of 3-35 months, only one patient died of tumor progression. Conclusion Laparoscopic approach for colorectal carcinoma and synchronous liver metastasis is safe and feasible in selected patients.

关 键 词：结直肠肿瘤 肝转移 腹腔镜 结直肠切除术 肝切除术 

分 类 号：R735[医药卫生—肿瘤]