腹腔镜外科技术在结直肠恶性肿瘤切除术中的应用

Laparoscopic procedures in the resection of colorectal cancers

目的 探讨腹腔镜在结直肠恶性肿瘤切除手术中的应用。 方法 经腹腔镜施行结直肠恶性肿瘤切除术 17例 ,其中行右半结肠根治性切除术 3例 ,乙状结肠根治性切除 3例 ,直肠癌行Dixon术 7例、Mile术 2例、Park术 2例。采用完全腹腔镜手术 6例 ,腹腔镜辅助手术 8例 ,手助腹腔镜手术 3例。 结果 全部病例均治愈出院 ,无死亡病例 ,无并发症发生 ,无中转开腹病例 ,手术时间 15 0～ 2 4 0min ,平均 190min ,术中出血 2 0～ 30 0ml,平均 5 5ml,术后平均住院 9 6d ,有 6例使用镇痛剂 ,术后近期随访 1～ 6个月无复发。 结论 经腹腔镜结直肠恶性肿瘤切除术是安全可行的 。

Objective To investigate the use of laparoscopy in the resection of colorectal cancers. Methods A total of 17 cases of colorectal cancer resection had been made by laparoscopy, including 3 cases of right hemicolectomy, 3 cases of sigmoid colon cancer radical resection, 7 cases of Dixon’s procedure, 2 cases of Mile’s procedure and 2 cases of Park’s procedure. The operation was accomplished totally laparoscopically in 6 cases, while the laparoscopic-assisted and hand-assisted excision were conducted in 8 cases and 3cases, respectively. Results All the cases were cured to be discharged from the hospital. There were no deaths or complications or conversions to open surgery.The operation time was 150～240 min (mean, 190 min). The intraoperative blood loss was 20～300 ml (mean, 55 ml). The average length of postoperative hospital stay was 9.6 days. Analgesic was required in 6 cases. Follow-up for 1～6 months found no recurrence. Conclusions Laparoscopic resection of colorectal cancer is safe and feasible,with a satisfactory short-term effect.