弧形切割吻合器在腹腔镜低位直肠癌前切除术中的临床应用  

Clinical application of curved cutter stapler in laparoscopic anterior resection of low rectal cancer

作　　者：沈荐[1] 李敏哲[1] 杜燕夫[1] 谢德红[1] 渠浩[1] 张峪东[1] 

机构地区：[1]首都医科大学附属北京朝阳医院普通外科,100020

出　　处：《中华胃肠外科杂志》2016年第3期284-286,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的初步评价弧形切割吻合器在腹腔镜低位直肠癌前切除术中应用的可行性。方法回顾性分析2014年7月至2015年7月首都医科大学附属北京朝阳医院普通外科采用弧形切割吻合器完成腹腔镜下低位直肠癌前切除的21例直肠癌患者的临床资料。结果全组21例患者均经弧形切割吻合器单次激发成功离断直肠远端并顺利完成手术，无中转开腹病例。手术时间110-0～180．0（140．5±16．6）min，术中出血50．0～100．0（66．8±11.4）ml，远端切缘1．0～3．0（1．8±0．7）cm。术后病理均未见远端切缘残留肿瘤细胞，其中Ⅰ期14例，Ⅱ期4例，Ⅲ期3例。全组术后均未发生吻合口出血及吻合口瘘。术后随访时间中位数为6（1～13）月，全组均未见肿瘤局部复发及远处转移。结论弧形切割吻合器用于腹腔镜低位直肠癌前切除术可行且疗效满意。Objective To make a preliminary assessment of the feasibility of Endo GIATM Radial Reload with Tri-StapleTM Technology （Radial Reload） in laparoscopic anterior resection of low rectal cancer. Methods Clinical data of 21 low rectal cancer patients undergoing laparoscopic anterior resection with the Radial Reload in our department between July 2014 and July 2015 were retrospectively analyzed. Results All the rectums were achieved complete transection by the first stapler device firing and all the operations were performed successfully. No patient were converted to open surgery. The operative time ranged from 110.0 to 180.0 （140.5 ± 16.6） minutes, the blood loss ranged from 50.0 to 100.0 （66.8 ± 11.4） ml, and the distal resection margin ranged from 1.0 to 3.0（1.8 ± 0.7） cm. Tumor cells were not discovered in all the postoperative pathological samples of distal resection margin. Among 21 cases, stage I was found in 14 eases, stage II in 4 cases and stage ! in 3 cases. There were no anastomotic bleeding and anastomotic leakage. There was no local recurrence and distant metastasis during a median follow-up of 6 months （1 to 13 months） postoperatively. Conclusion The application of Radial Reload in laparescopie anterior resection of low rectal cancer is feasible with satisfactory efficacy.

关 键 词：直肠肿瘤 低位 弧形切割吻合器 直肠前切除术 腹腔镜 

分 类 号：R735.37[医药卫生—肿瘤]