腹腔镜结直肠癌切除术27例初步体会

Preliminary experience of laparoscopic resection of colorectal cancer for 27 cases

目的总结腹腔镜结直肠癌手术的初步体会。方法自2008年9月至2010年7月共收治结直肠癌患者27例,均在全麻下行腹腔镜结直肠癌切除术,术中遵循无瘤原则,分析总结术中情况及近期疗效。结果 27例中25例顺利完成腹腔镜手术,手术时间120～240min,术中失血量80～400ml,直肠清扫淋巴结6～14枚,结肠清扫淋巴结13～25枚,术后肠功能恢复时间37～62h。1例左输尿管中段挫伤,2例切口感染,无术后出血、吻合口漏等并发症发生,总并发症发生率为11.1%,无围手术期死亡病例。结论腹腔镜结直肠手术的学习过程是经验累积、总结的过程,规范化学习可以缩短"学习曲线",腹腔镜结直肠手术安全可行,短期效果理想。

Objective To summarize the preliminary experience of laparoscopic resection of colorectal cancer. Methods From September 2008 to July 2010,27 patients with coloreetal cancer were treated by laparoscopic resection of colorectal cancer,all patients under general anesthesia,and follow the principle of non-tumor surgery,analyze and summarize the situation and the recent effect of intraoperative. Results Twenty five cases received laparoscopic operation successfully. Operating time was from 120 to 240 min, the volume of bleeding during operation was from 80 to 400 ml, the number of lymph nodes of rectal cancer was from 6 to 14, and colonic cancer from 13 to 25, the intestinal function after operation restored within 37 to 62 hours. All of 25 cases , 1 case was injured on middle ureter, and 2 infection of incisional wound. There were no postoperative bleeding, anastomotic leakage death. Conclusions Thecourse of laparoscopic colorectal operation is the course accumulation and summarization of experience. We can short the course by standardization. Laparoscopic colorectal operation is safe and feasible, outcome is satisfied in the near future.