采用自制套管器经肛门取出标本的腹腔镜结直肠癌根治术的可行性研究  

Laparoscopic-assisted natural orifice specimen extraction radical left colectomy

作　　者：张诗峰[1] 丁志杰[1] 邱兴烽[1] 袁思波[1] 闫峰[1] 洪心雅[1] 蔡建春[1] 

机构地区：[1]厦门大学附属中山医院胃肠外科厦门大学医学院胃肠肿瘤研究所,361004

出　　处：《中华胃肠外科杂志》2015年第6期577-580,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的：探讨腹腔镜辅助结直肠癌根治术采用自制套管器经肛门取出标本的可行性。方法2014年1—9月间，厦门大学附属中山医院胃肠外科对15例患者施行腹腔镜辅助结直肠癌根治术时采用自制套管器（免辅助切口肛门套管器，设有引导管、外套管、后盖和器械孔盖，专利号ZL 201420203735．X）经肛门取出标本。结果15例患者中降结肠癌3例，降结肠与乙状结肠交界处癌2例，乙状结肠癌6例，中上段直肠癌4例。全组患者均顺利完成手术，手术时间103～337（中位数257） min，术中出血量20～200（中位数50） ml，术后排气时间1～5（中位数3） d。无一例发生吻合口出血或吻合口瘘等术后并发症，住院天数11～21（中位数14） d。随访1～8月，所有患者生活质量良好，排粪功能基本正常，未发现肿瘤复发或转移。结论腹腔镜辅助结直肠癌根治术采用自制套管器经肛门取出标本安全可行。Objective To explore the feasibility of laparoscopic-assisted natural orifice specimen extraction radical left colectomy. Methods Retrospective analysis was performed on clinicopathological dada of 15 colorectal patients who were treated by laparoscopic-assisted anal specimen extraction radical left colectomy with self-developed surgical instrument Cai tube between January and September in 2014. Tumor location included descending colon （n=3）, the junction of descending colon and sigmoid colon （n=2）, the sigmoid colon （n=6） and upper rectum （n=4）. Clinical efficacy of patients was observed. Results There were no perioperative deaths or postoperative complications , such as anastomotic bleeding or leakage. The median operation time was 257 （range 103-337） min, median blood loss was 50（range 20-200） ml, median time to first flatus was 3（range 1-5） d and median hospital stay was 14 （range 11-21） d. All the patients had good quality of life and normal defecation function without tumor recurrence or metastasis after 1-8 months of follow-up. Conclusion Laparoscopic-assisted anal specimen extraction radical left colectomy is safe and feasible.

关 键 词：结直肠肿瘤 腹腔镜 自制套管器 经自然腔道取出标本 

分 类 号：R735.34[医药卫生—肿瘤]