腹腔镜技术在低位直肠癌根治术中的应用

The application of laparoscopic technique in low rectal cancer surgery

目的探讨腹腔镜技术在低位直肠癌手术中的应用与效果。方法回顾性分析2009年1月~2010年8月39例腹腔镜直肠癌根治术患者的临床资料。结果 39例患者中35例顺利完成腹腔镜手术。4例中转开放手术,无手术死亡病例,无术后出血、吻合口漏、吻合口狭窄发生,手术平均时间150 min,术中出血量50~150ml,术后2~4 d胃肠功能恢复,所有标本残端无癌细胞浸润或残留,清扫淋巴结数6~27个。术后平均住院时间8d,术后随访至2010年8月,死亡1例,局部复发1例。结论腹腔镜低位直肠癌根治术不仅可达到开腹根治术的目的 ,而且具有操作安全、微创、恢复快、保肛率高的优点。

Objective To investigate the application and effects of laparoscopy technique in low rectal cancer surgery.Method The clinical data of 39 cases of laparoscopic radical rectectomy for rectal cancer patients from January 2009 to August 2010 were analyzed retrospectively.Results 35 cases of 39 patients successfully completed by laparoscopic surgery.4 cases were converted to open laparotomy with no operative deaths,postoperative bleeding,anastomotic leakage,anastomotic stenosis.The average operative time break was 150 min,Blood loss was 50~150 ml,gastrointestinal function recovered after operation at 2~4 d.All specimens stump were found with non-cancer cell infiltration,number of lymph node dissection was 6~27.The average hospital stay after surgery is 8 days.There was 1 case died and 1 case local recurrenced in the postoperative follow-up until August 2009.Conclusion The purpose of abdominal radical surgery not only can be achieved by the Laparoscopic rectal cancer resection,but also safe,minimally invasive,quick recovery and the advantages of high rate of sphincter preservation.However,its long-term effect has yet to be proved by the follow-up observation of a large number of cases.