改良腹腔镜Dixon手术26例

Modified Laparoscopic Dixon Surgery: Report of 26 Cases

目的 探讨改良的腹腔镜Dixon手术治疗中低位直肠癌的方法与疗效. 方法 2004年9月～2007年4月,对26例中低位直肠癌行改良的腹腔镜Dixon手术,术中直肠肿瘤从肛门拖出并经肛门进行切除和肠吻合. 结果 26例均顺利完成手术,手术时间(166.3±48.1)min,术中出血(235.4±124.7)ml,无输尿管损伤、排尿障碍、吻合口漏等并发症.术后肛门排气时间(2.9±0.7)d,术后住院时间(8.8±1.4)d.术后随访6～27个月,平均15.7月.局部复发3例,5例大便次数增加,其他18例控便功能良好. 结论 短期随访提示该术式创伤小,是治疗中低位直肠癌的安全、有效的方法.

Objective To investigate the safety and therapeutic effect of modified laparoscopic Dixon surgery for mid-low rectal carcinoma. Methods From September 2004 to April 2007,26 patients with mid-low rectal carcinoma were selected to receive modified laparoscopic Dixon surgery.Through the anus,the rectum was pulled out,the tumor was removed,and then colon-rectum anastomosis was performed.Results All the operation was completed successfully.The average operation time was(166.3 ± 48.1) min,and the mean blood loss was(235.4 ± 124.7) ml.No patient had urethral injury,dysuria,anastomotic leakage,or other complications after the operation.The patients expelled gas(2.9±0.7) days after the operation.Their mean hospital stay was(8.8±1.4) days.During a follow-up of 15.7 months(6 to 27 months),3 patients had local recurrence,5 patients showed increased frequency of stool,and 18 had satisfied anal function.Conclusion The short-term results indicate that the modified laparoscopic Dixon surgery is safe and effective for mid-low rectal carcinoma,and is associated with minimal invasion.