侧方牵引尾侧中间入路在腹腔镜直肠癌根治性切除术中的应用  

Application of lateral traction and medial-caudal approach in laparoscopic radical resection of rectal cancer

作　　者：谢杰斌[1] 张维 李勋[1] 唐锦[1] 魏寿江[1] XIE Jie-bin;ZHANG Wei;LI Xun(Department of Gastroenterological Surgery,the Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China;Department of Internal Medicine,Langzhong People's Hospital)

机构地区：[1]川北医学院附属医院胃肠外科,川北医学院肝胆胰研究所,四川南充637000 [2]阆中市人民医院内科

出　　处：《腹腔镜外科杂志》2021年第7期513-516,共4页Journal of Laparoscopic Surgery

基　　金：川北医学院科研发展计划重点资助课题(CBY15-A-ZD008)。

摘　　要：目的:探讨侧方牵引尾侧中间入路在腹腔镜直肠癌根治性切除术中应用的可行性及临床价值。方法:分析2018年1~12月采用经侧方牵引尾侧中间入路为36例直肠癌患者行腹腔镜直肠癌根治性切除术的操作流程及术后疗效,其中男20例,女16例,平均(59.9±12.3)岁。结果:36例手术均顺利完成,吻合后肠管、系膜均无张力,手术时间平均(91.8±13.7)min,直肠后间隙游离时间平均(17.1±5.3)min,系膜裸化时间(9.0±2.3)min,淋巴结清扫总数(14.9±10.5)枚,术中出血量(20.3±9.8)mL。术后肛门首次排气时间(2.9±0.7)d,无一例出现围手术期死亡,术后发生吻合口漏1例、肺部感染1例,无吻合口狭窄发生,术后平均住院(7.9±1.2)d。结论:经侧方牵引尾侧中间入路的直肠癌根治术安全、可行,具有难度低的优点。Objective:To investigate the clinical application value and feasibility of lateral traction and medial-caudal approach in laparoscopic radical resection of rectal cancer.Methods:The operation procedure and postoperative efficacy of 36 rectal cancer patients from Jan.2018 to Dec.2018 who underwent laparoscopic radical resection using lateral traction and medial-caudal approach were analyzed.Among these patients,20 patients were male,16 patients were female,and the mean age was(59.9±12.3)years old.Results:All the 36 operations were successful.There was no tension in the intestine and mesenteria after anastomosis in all the 36 patients.The mean operation time was(91.8±13.7)min,the mean dissection time of retrorectal space was(17.1±5.3)min,the mesentery blanking time was(9.0±2.3)min,the average number of lymph nodes harvested was(14.9±10.5),and the mean estimated blood loss was(20.3±9.8)mL.The first exhaust time was(2.9±0.7)d.There was no perioperative death.There was 1 case of anastomotic leakage and 1 case of pulmonary infection.No anastomotic stenosis occurred and the average postoperative hospital stay was(7.9±1.2)d.Conclusions:Laparoscopic radical resection of rectal cancer in lateral traction and medial-caudal approach is safe and feasible with advantage of reduced difficulty.

关 键 词：直肠肿瘤 腹腔镜检查 侧方牵引尾侧中间入路 

分 类 号：R735.37[医药卫生—肿瘤]