经腹腔镜手术治疗结直肠肿瘤的临床意义

Clinical significance of treating colorectal carcinomas with peritoneoscopic operation

目的探讨腹腔镜结直肠肿瘤手术的可行性、安全性及优缺点。方法经腹腔镜行结直肠肿瘤手术48例,包括右半结肠切除,Dixon手术,乙结肠癌姑息切除,左半结肠切除,Miles手术,乙结肠造瘘和腹腔镜探查术。结果48例成功完成手术,其中1例因为降结肠肿瘤与周围肠管粘连严重而中转开腹。手术时间平均158min。术后无并发症发生,术后平均住院8.5d。术后随访1～36个月。结论腹腔镜结直肠肿瘤手术技术上是可行的、安全的,具有手术创伤小、术后恢复快、胃肠道干扰小、术后疼痛轻,疤痕小等优点,尤其在手术中的组织解剖结构的辨别中有其特有的优势。手术后的长期效果有待进一步观察。

[ Objective ] To explore the feasibility, safety, advantage and disadvantage of treating colorectal carcinoma with peritoneoseopic operation. [ Methods ] Forty-eight patients of coloreetal carcinoma received peritoneoseopic operation, including right hemicolectomy, Dixon operation, palliative resection of sigmoid colon cancer, left hemicolectomy, Miles operation, fistulization of sigmoid colon and peritoneoscopic exploration. [ Results ] All of 48 patients received operations successfully, while one of them needed a celiotomy in the operation because of severe adhesion between the descending colon cancer and the peripheral intestine. The mean time of operations was 158 minutes, the mean length of post-operative stay was 8.5 days. There was no complication after operation. And the patients were followed up for 1-36 months. [ Conclusions ] Peritoneoscopic operation for the treatment of colorectal carcinoma is technically feasible and safe, and it shows some advantages such as minimal invasion, short recovery time, little gastrointestinal influence, slight postoperative hurt and small scar. It is of superiority especially in discernment of anatomic structures during operation. However, its long-term effects after operation need further researches.