腹腔手术史对腹腔镜辅助结直肠癌手术的影响  

Laparoscopic-assisted surgery of cancer with abdominal operation history:report of 148 patients

作　　者：兰忠民[1] 汤小龙[1] 王成锋[1] 梁建伟[1] 周志祥[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院腹部外科,北京100021

出　　处：《中国医刊》2014年第12期42-44,共3页Chinese Journal of Medicine

摘　　要：目的探讨腹腔手术史对腹腔镜辅助结直肠癌手术的影响,以及腹腔镜在既往有手术史的结直肠癌患者治疗中的可行性及安全性。方法回顾性分析148例既往有腹腔手术史的腹腔镜辅助结直肠癌手术患者的临床资料,对比分析同期673例既往无腹腔手术史的腹腔镜辅助结直肠癌手术病例。结果腹腔手术史合并结直肠癌约占18%(148/821),腹腔手术史对腹腔镜辅助结直肠癌手术的手术时间、术中出血、中转开腹、术后并发症(术后出血、吻合口漏、肠梗阻、腹腔感染、二次手术)、术后排气时间、平均住院时间、手术切缘、平均清扫淋巴结数目无影响(P均>0.05)。结论腹腔手术史对腹腔镜辅助结直肠癌手术围术期无明显影响。腹腔镜手术对于既往有腹腔手术史的结直肠癌患者的治疗是安全可行的。Objective To investigate the treatment and safety of laparoscopic-assisted surgery of cancer with abdomi-nal operation history. MethOd 148 cases of rectal and colonic cancer with abdominal operation history and 673 cases colorectal cancer without abdominal operation history under the laparoscopic-assisted surgery were retrospectively in-vestigated in this study. Result Patients with history of colorectal cancer surgery account for about 18% （148/821） of total patients. There was no significant differences between these two groups in operative time , blood loss , lapa-rotomy , postoperative complications （ postoperative bleeding , anastomotic leak , ileus , postoperative abdominal infection, secondary surgery ） , postoperative discharge time, the average length of hospital stay, surgical margin, the average number of dissected lymph nodes （P〉0. 05）. COnclusiOn Abdominal operation history has no significant influence in the laparoscopic-assisted reoperation. The laparoscopic reoperation for colorectal cancer patients with ab-dominal operation history is safe and feasible.

关 键 词：腹腔手术史 腹腔镜辅助 结肠癌 直肠癌 

分 类 号：R735.3[医药卫生—肿瘤]