腹腔镜下直肠切除术的器械应用与管理

Application and management of instruments during laparoscopic rectal resection

目的探讨腹腔镜下直肠切除术的器械应用与管理特征。方法72例腹腔镜下直肠前切术和腹会阴联合直肠癌根治术患者,采用统一的临床路径治疗方案和整体护理。结果除5例中转开腹外,67例完成腹腔镜下直肠切除术,手术时间130～210min,平均155min;术中平均出血量190mL。结论手术室建立腹腔镜组,培养熟练掌握腹腔镜结直肠切除手术器械使用与维护、清洗、包装和灭菌的技术人才,能不断完善腹腔镜手术的操作规范,促进腹腔镜下结直肠手术的发展。

[Objective] To explore the application and management of instruments during laparoscopic rectal resection. [Methods] 72 cases received anterior resection and abdominoperineal resection of rectum underwent the same clinical therapy and holistic nursing. [Results] Laparoscopic rectal resection was performed successfully in 67 cases, the other 5 cases converted to laparotomy. The operation time was 130~210 min with the mean of 165 min. The mean bleeding during operation was 190 mL. [Conclusions] A laparoscopy group should be found in operation room. Specialized nurses can be trained to master basic practice, maintenance, cleaning, packing and sterilization of laparoscopic instruments for laparoscopic colorectal resection. As a result, it can improve the performing standardization of laparoscopic operation and promote the development of laparoscopic colorectal resection.