腹腔镜辅助TME直肠癌根治性切除前路吻合术：附42例报告

Laparoscopy-assisted total mesorectal excision for anterior resection of rectal cancer:a report of 42 cases

目的探讨腹腔镜辅助全直肠系膜切除在直肠癌根治中的效果和方法。方法对42例腹腔镜辅助全直肠系膜切除直肠癌根治前路吻合术的临床资料进行分析总结。结果手术均经腔镜完成TME及保肛手术,术中直肠远端使用反复闭合器闭合,前路吻合采用吻合器完成。手术时间170～230min,平均195min。术中出血10～30mL,平均15mL。术后肠功能恢复平均时间32h。1例术后并发排尿困难,1例术中并发皮下气肿。无切口感染,无吻合口漏。结论腔镜辅助行TME直肠癌根治性切除前路吻合术是安全可行的。

Objective To explore the feasibility of laparoscopy-assisted total mesorectal excision （ TME ） for anterior resection of rectal cancer. Methods The clinical records of 42 patients with rectal cancer who underwent laparoscopic TME from April 2006 to July 2008 were analyzed retrospectively. Results All the laparoscopic TME with anal sphincter preservation operations were successful; no case was converted to open procedure. The distal end of rectum was anastomosed by a reusable linear stapler. The average operative time was 195 min （170-230 min） and the operative blood loss 15 mL （10 -30 mL）. The time for bowel function recovery was 32 hours. One patient had postoperative dysuria, and one had intraoperative subcutaneous emphysema. No anastomotic leakage or infection of incisional wound occurred. Conclusions Laparoscopy-assisted anterior resection for rectal cancer is safe and feasible.