腹腔镜异时性结直肠癌根治术的临床疗效  

Laparoscopic resection of metachronous colorectal carcinoma

作　　者：白洁[1] 刘兴华[1] 蔡明[1] 张鹏[1] 高金波[1] 王国斌[1] 陶凯雄[1] 帅晓明[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院胃肠外科,武汉430022

出　　处：《中华普通外科杂志》2017年第1期9-11,共3页Chinese Journal of General Surgery

基　　金：国家卫生和计划生育委员会公益性行业专项资助项目（201402015）

摘　　要：目的探讨腹腔镜异时性结直肠癌根治术的临床应用价值及可行性。方法回顾性分析2013年1月至2015年12月华中科技大学同济医学院附属协和医院胃肠外科收治的13例异时性结直肠癌患者的临床资料，均采用腹腔镜结直肠癌根治术治疗。结果本组13例异时性结直肠癌患者中行右半结肠癌根治术3例．横结肠癌根治术1例，左半结肠癌根治术2例。乙状结肠癌根治术4例，直肠癌根治术3例。平均手术时间（156±9）min，术中平均出血量为（66±21）ml，无中转开腹。2例行预防性造瘘，术后平均（2．5±0．7）d恢复排气、排便。1例术后出现腹腔出血，行急诊手术后症状缓解。平均住院时间（26．2±2．9）d。中位随访12个月（5—30个月），均无术后并发症发生，均无癌复发。结论腹腔镜下异时性结直肠癌根治术可获得满意治疗效果。Objective To evaluate laparoscopic radical resection of metachronous colorectal carcinoma. Methods A total of 13 patients with metachronous colorectal carcinoma undergoing laparoseopic resection in Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2013 to December 2015 were analyzed retrospectively. Results The mean time of surgery was （ 156 ± 9） min. Tumors were located in the right hemicolon in 3 cases, in the transverse colon in one, in the left hemicolon in 2, in the sigmoid colon in four and in the rectum in 4. The mean blood loss was （66 ±21 ） ml. There was no conversion to open surgery. Two patients were done with protective ileostomy. Postoperative gastrointestinal function recovery time was （2. 5 ± 0. 7） days. One postoperative intra-abdominal bleeding was successfully controlled laparoscopically. Posteperative length of hospital stay was （ 26. 2 ± 2. 9 ） days. The median follow-up was 12 months （ 5 - 30 months） with no cancer recurrence. Conclusions Laparoscopic radical resection of metachronous eolorectal carcinoma has good curative effect, and high success rate in spite of previous history of laparotomy.

关 键 词：结直肠肿瘤 直肠结肠切除术 重建性 腹腔镜 

分 类 号：R735.34[医药卫生—肿瘤]