腹腔镜行TME加保肛手术治疗低位直肠癌:附18例报告

Laparoscopic TME with ultra-low sphincter-saving procedure for low rectal cancer:a report of 18 cases

目的探讨腹腔镜行TME+保肛手术治疗低位直肠癌的安全性和可行性。方法回顾分析近3年半笔者采用腹腔镜行TME+保肛改良手术治疗低位直肠癌18例患者的临床资料。结果18例手术均顺利完成。手术时间(165.2±45.6)min,术中出血量(146.7±84.5)mL,术后腹腔引流量(170.1±47.2)mL,术后肛门排气时间(3.1±0.7)d,术后住院时间(8.7±1.4)d,淋巴结清除数(12.1±3.2)枚。手术后大便次数增加5例,均在1年左右恢复至近正常状态。无输尿管损伤、排尿障碍、大便失禁及吻合口瘘等并发症。结论腹腔镜行TME+保肛手术治疗低位直肠癌是安全、可行的,体现了手术微创的优越性。

Objective To study the safety and feasibility of laparoscopic TME with ultra-low sphincter-saving procedure for low ;rectal cancer. Methods The clinical data of laparoscopie TME with ultra-low sphinctersaving modified procedure for low rectal cancer in the recent three and a half years in our hospital were analysed retrospectively. Results Eighteen cases were selected in this study and all surgery was performed successfully. The average operative time was （165. 2±45. 6 ） rain, the mean volume of bleeding was （146.7±84. 5 ）mL, the volume of abdominal drainage was（ 170.1±47.2）mL, postoperative time of bowel gas passage was（3. 1±0.7）d, postoperative hospital stay was（8.7±1.4）d, and the number of lymphnode dissection was （ 12.1 ±3.2 ）.5 cases had increased frequency of stool and all these patients recovered to near normal within one year. No other complications, such as ureteral ingury, dysuresia, fecal incontinence, or anastomotic leakage, were experience. Conclusions This study shows that it is safe and feasible to perform laparoscopic TME with ultra-low sphincter-saving procedure for low rectal carcinoma, and with the advantage of minimal invasion.