腹腔镜辅助下结直肠手术

<title>paroscopic assisted colorectal resection

目的探讨腹腔镜辅助下结直肠手术的优点及不足.方法2003年3月至2004年6月共行腹腔镜辅助下结直肠手术137例,10例中转剖腹,127例腹腔下游离肠段,离断系膜血管,行腹壁4～5cm小切口,将病变肠段取出,体外或腹腔内吻合肠管.127例中良性肿瘤8例,癌119例;左右半结肠切除术各21、6例,乙状结肠、直肠切除术各33、67例.结果病人术中出血10～50ml,术后1～2天下床活动,术后2天开始进食,术后住院7～10天(平均8.5天).结论结肠良性肿瘤、恶性肿瘤早期或进展期(结肠肿瘤直径＜5cm)的病例均可行腹腔镜辅助下切除手术,晚期结直肠癌腹腔镜探查可有助于剖腹术式的选择.

<abstract>jective To evaluate whether the laparoscopic assisted colorectal resection can approach the same scope and effect than the conventional open abdomino-perineal resection, and the advantage and disadvantage of laparoscopic assisted colorectal resection. Methods From March 2000 to June 2004, 137 patients accepted laparoscopic assisted colorectal resections, of which 10 patients had turned to be performed by open abdomino-perineal resections during the laparoscopic intervention. In the remaining 127 patients, laparoscopic procedures were performed by mobilizing the colon or rectum, breaking down the vessels of mesocolon, removing the specimen through the 4-5cm skin wound, and the anastomosis were in or out of the abdomen. The right colon resections were 6 cases, the left colon resections were 21 cases, sigmoidectomy were 33 cases, and rectum resections were 67 cases. In this study, 8 cases were carcinoids and 119 cases were colorectal cancer. Results The blood loss of patient who received laparoscopic assisted colorectal resection was 10-50ml, the patients can walk after 1-2 days of operation, and they can have liquid food after 2 days of operation. The duration of hospitalization was 7-10 days (the average was 8.5 days) . Conclusion Beside the carcinods of the rectum, the early and developed colorectal cancer (the tumor diameter was within 5cm) can be performed effectively by laparoscopic assisted colorectal resection. For the advanced colorectal cancer, the laparoscopic assisted intervention can help the diagnosis and the choice of the surgical procedure.