腹腔镜直肠癌根治术中吻合口张力探讨  

Investigate the tension of anastomotic stoma for laparoscopic radical resection of rectal cancer

作　　者：陈斌[1] 陈健健[1] 李柳生[1] 

机构地区：[1]茂名市人民医院普通外科,525000

出　　处：《中华腔镜外科杂志（电子版）》2016年第4期248-250,共3页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的 探讨腹腔镜直肠癌根治术中降低吻合口张力的方法和效果。方法 总结分析腹腔镜直肠癌Dixon根治术243例。全部患者在根部离断肠系膜下动脉,仅留下肠管和贴近肠管边缘的血管弓和组织。其中降结肠游离到结肠脾曲86例,占35.4%。在髂前上棘下方做减张缝合57例,占23.4%。结果 全部病例均有足够的肠管做吻合,吻合口完全无张力。手术时间85~145 min,平均135 min;术中出血量5~100 ml,平均10 ml。标本检查淋巴结数目9~17枚。出现吻合口漏2例,发生率为0.8%。结论 腹腔镜直肠癌手术Dixon根治术中充分游离肠管和必要时的减张缝合能确保吻合口无张力,可降低吻合口漏的发生率。Objective To investigate the technique and effect that reduced tension of anastomotic stoma for laparoseopic radical resection of rectal cancer. Methods Summary and analysis the clinical data of 243 patients that were carried out surgery of Dixon with laparoseopie radical resection of rectal cancer. All cases disconnect the inferior mesenteric artery in roots and only staged the edge vascular arcades of the colon. The 86 patients of the descending colon were freed to the splenic of colon, the incidence rate was 35.4%. The 57 patients were sutured for redueeing the tension of anastomotie stoma in before and below of the anterior superior iliac spine. The incidence rate was 23.4%. Results All cases of anastomotic were without tension. The operation time was 85-145 min, average 135rain. The amount of bleeding was 5-100 ml, the average was 10 ml. The specimens that was checked the number of lymph nodes was 9-17. The anastomotic leakage occurred in 2 cases, The incidence rate was 0.8%. Conclusions It is necessary to ensure that anastomotie completely without tension in laparoscopie radical resection with Dixon of rectal cancer, when the length of colon is not enough, the colon should free to the splenic flexure . It can reduce the tension of anastomotie stoma that sutured the colon to the before and below of the anterior superior iliac spine. This is can reduce the incidence of the anastomotic eakage.

关 键 词：直肠癌 腹腔镜 根治术 吻合口张力 

分 类 号：R735.37[医药卫生—肿瘤]