腹腔镜直肠癌根治切除术的临床应用

Clinical application of laparoscopic radical operation for rectal neoplasms

目的 :探讨腹腔镜手术治疗直肠癌的方法与可行性。方法 :2 0 0 0年 3月至 2 0 0 4年 4月行腹腔镜直肠癌根治切除术 2 1例 ,其中Dixon手术 8例 ,Miles手术 13例。结果 :手术均获成功 ,无中转开腹 ,平均手术时间 2 2 0min ,术中出血量平均 70ml,术后肠功能恢复时间平均 2 8h ,生活质量好。随访 4～ 4 1个月无复发转移 ,平均住院时间 12 8d。Miles手术住院费用与常规手术无明显差别。结论 :腹腔镜治疗直肠癌具有创伤小、并发症少、出血少、肠功能恢复快 ,住院时间短等优点。通过腹腔镜直肠癌手术的学习曲线 ,具备丰富的手术经验与娴熟的专业技能是腹腔镜直肠癌手术达到根治的保证。

Objective:To investigate the method and its possibility of laparoscopy in radical resection of rectal cancer.Methods:Twenty-one cases were performed radical resection with laparoscopy,8of them were done Dixon and13of them were done Miles operation.Results:All cases were successful.The average operative time was220min.The amount of bleeding during operation was from30to300ml(mean70ml).The function of intestine was come to within mean of28h.The average hospital stay was12.8d.There was no recurrence metastasis in the follow up of4-41months.There was no obvious difference in the operation expense between the Miles’operation and the traditional laparotomy.Conclusions:Laparoscopic radical resection for rectal cancer has some advantages,such as little wound,few complica-tions,blood loss and hospital stay and so on,but it demands plenty of experience and great skill.