腹腔镜结直肠癌根治术的临床应用

Laparoscopic radical surgery for colorectal carcinoma

目的探讨腹腔镜下根治性结直肠癌切除术的可行性、方法和效果。方法对2例结肠癌行腹腔镜根治性右半结肠切除,1例直肠癌行腹腔镜Miles根治术。结果3例均成功完成腹腔镜手术。手术时间:第1例右半结肠切除240 min,第2例右半结肠切除270 min,Miles手术300 min。术中出血量分别为120 ml、200 ml和150 ml。淋巴结清扫数分别为16枚、8枚和5枚。术后胃肠功能恢复时间分别是3 d5、d和4 d。进流质时间分别是4 d、6 d和5 d。下床活动时间分别为4 d5、d和5 d。术后近期效果良好,无1例手术并发症。结论腹腔镜结直肠癌根治术是安全、可行的,具有创伤小、术后恢复快等微创优势,能够达到与开腹手术相当的根治效果。

Objective To explore the feasibility, procedures and clinical outcomes of laparoscopic radical surgery for colorectal carcinoma. Methods Radically laparoscopic right hemicolectomy was performed in two cases of colonic carcinoma. Laparoscopic Miles operation was performed in one case of rectal carcinoma. Results The operative time for laparoscopic right hemicolectomys and Miles operation were 240 min, 270 min, and 300 min, respectively. The blood loss for them were 120 ml, 200 ml, and 150 ml, respectively. The number of dissected lymph nodes were 16, 8, and 5, respectively. The time for gastroin-testinal function recovery were 3 d, 5 d, and 4 d, respectively. The time for the start of oral liquids were 4 d, 6 d,and 5 d, respectively. The time for the patients to stand up were 4 d, 5 d, and 5 d, respectively. The postoperative outcomes were satisfactory. No complications were found. Conclusion laparoscopic radical surgery for colorectal carcinoma is a safe, feasible, and minimally invasive technique and can achieve the same results of abdominal opening for the patients with colorectal carcinoma.