无切口腹腔镜下直肠外翻技术的直肠癌低位前切除术的近期疗效  

Short-term outcomes of incisioniess laparoscopic low anterior resection using prolapsing technique for rectal cancer

作　　者：周海涛[1] 周志祥[1] 梁建伟[1] 王征[1] 张兴茂[1] 胡俊杰[1] 曾维根[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院腹部外科,100021

出　　处：《中华肿瘤杂志》2015年第1期63-66,共4页Chinese Journal of Oncology

基　　金：北京协和医学院协和青年科研基金（2013-185）

摘　　要：目的探讨经肛门自然腔道标本取出的无切口腹腔镜低位前切除术治疗中低位直肠癌患者的可行性、适应证和近期疗效。方法收集应用直肠外翻拖出技术，行无切口的腹腔镜直肠癌低位前切除术患者的临床资料，分析患者术后排气时间、淋巴结清扫数目、吻合口瘘发生率等临床特征。结果27例患者均行全腹腔镜直肠癌低位保肛术，中位手术时间为135min，中位手术出血量为50ml，中位术后恢复排气时间为48h，中位术后住院时间为9d。27例患者远端切缘均未发现癌细胞，中位淋巴结清扫数目为18枚，术后发生吻合口瘘1例。结论在经选择的适合此术式的患者中，利用直肠外翻技术的无切口腹腔镜直肠癌低位前切除术切实可行、安全可靠、近期疗效满意。Objective Laparoscopic-assisted surgery for colorectal cancer has been widely spread worldwide. To avoid the invasiveness of abdominal wound and get better good-looking, incisionless laparoscopic low anterior resection with transanal natural orifice specimen extraction using prolapsing technique for rectal cancer has been developed in our center. The aim of this study was to evaluate the feasibility, safety and short-term outcomes of this technique. Methods From January 2013 to October 2013, twenty-seven patients with rectal carcinoma were treated by incisionless laparoscopic low anterior resection, and the data of these patients were collected and retrospectively analyzed to assess the value of this technique. Results All operations were successfully accomplished without conversion to open surgery or laparoscopic-assisted surgery. The mean operation time was 135 minutes. The mean blood loss was 50 ml. The mean first bowel movement was 48 hours. The post-operative hospital stay was 9 days. All patients had clean distal margin and the mean number of dissected lymph nodes was 18. One patient had anastomotic leakage. Conclusions Incisionless laparoscopic low anterior resection with transanal natural orifice specimen extraction using prolapsing technique for rectal cancer appears to be feasible, safe and oncologically acceptable with a satisfactory short-term outcome for selected cases.

关 键 词：腹腔镜检查 直肠肿瘤 自然腔道标本取出 经肛门标本取出 直肠外翻 低位前切除 

分 类 号：R735.37[医药卫生—肿瘤]