手助腹腔镜下结肠癌切除:附50例报告

Hand-assisted laparoscopic colectomy:a report of 50 cases

目的探讨手助腹腔镜技术(HALS)在切除结肠癌术中的应用。方法回顾性分析近4年余笔者采用手助腹腔镜技术治疗50例结肠癌患者的临床资料。其中2例因肿瘤侵及十二指肠,1例因瘤体巨大,另1例术中损伤右侧输尿管而中转开腹手术。结果全组手术时间为(163.8±15.1)min,术中出血量(89.9±52.3)mL,清除淋巴结(18.1±7.9)枚,标本长度(30.1±6.1)cm,术后住院日(8.1±1.9)d。中转开腹手术率8.0%(4/50)。无手术死亡,平均随诊18个月,未发现辅助切口和戳口处肿瘤复发。结论HALS用于治疗结肠癌具有手术创伤小、术后疼痛轻恢复快等优点。

Objective To evaluate the role of using the hand-assisted laparoscopic surgery （HALS） for colectomy. Methods The data of 50 patiens with colonic cancer treated with hand-assisted laparoscopic technique between Mar 2002 and Aug 2006 were analyzed retrospectively. Results The rate of conversion from HALS to open surgery was 8.0% （4/50）. The main reason for conversion was tumor invasion and large-sized tumor. The mean operation time was （ 163.8± 15. 1 ） min. The mean blood loss was （ 89.9 ± 52.3） mL. The mean number of removed lymph nodes was （ 18.7 ± 7.9 ）. The mean length of the resected specimen was （ 30. 1 ± 6. 1 ） cm. The mean postoperative hospital stay was （ 8. 1 ± 1.9 ） day and incision length was （6.9 ±0. 1 ）cm. No operative death occurred. The mean time of follow-up was 18 months. No trocar site or incision recurrence was found. Conclusions These results suggest that HALS colectomy for colon cancer is mini-traumatic, has less postoperative pain and recovery is fast.