腹腔镜辅助中低位直肠癌全直肠系膜切除术20例分析

LAPAROSCOPIC-ASSISTED TOTAL MESORECTAL EXCISION IN THE TREATMENT OF MIDDLE-LOW RECTAL CANCER:AN ANALYSIS OF 20 CASES

目的总结腹腔镜辅助治疗中低位直肠癌的临床经验及疗效。方法回顾性分析2000年1月~2002年12月行腹腔镜辅助治疗中低位直肠癌20例的临床资料。其中14例行腹腔镜低位直肠前切除术,6例行腹腔镜腹会阴联合切除术。结果19例获得成功,1例术中心肌梗死死亡,无中转开腹,平均手术时间（240±26）min,平均出血100mL,无副损伤,平均住院时间8.5d。结论腹腔镜辅助治疗中低位直肠癌是可行和安全有效的。在无超声刀、血管速结扎系统设备下,用单极和双极电凝同样能够完成腹腔镜辅助中低位直肠癌全直肠系膜切除术。

Objective To summarize and evaluate the clinical experience and outcomes of lapareoscopic-assisted total mesorectal excision treating middle-low rectal cancer. Methods Retrospectively 20 cases of rectal cancer with laparoscopic-assisted total mesorectal excision from January 2000 to December 2002 wre reviewed. Laparoscopic-assisted low anterior resection of rectum were performed in 14 cases. Laparoscopic-assisted abdominoperineal resection were performed in 6 cases. Results Laparoscopic-assisted total mesorectal excision were performed successfully in 19 cases except one case died of myocardial infarction on operation. No case was converted to open procedures and existed concomitant injury. The mean operating time was（240±26）min. The mean operative blood loss was 100 mL. The mean length of stay was 8.5 days. Conclusion Laparoscopic-assisted total mesorectal excision in treating middle-low rectal cancer is feasible, safe and effective. Total mesorectal excision can be accomplished without Ultrasound knife or LigarSure.