结直肠癌合并肠梗阻的肠镜与腹腔镜联合微创手术(附14例报告)

The mini-invasive surgery for colorectal carcinoma with intestinal obstruction under enteroscope and laparoscope

目的探讨结直肠癌合并肠梗阻的微创手术治疗方法。方法回顾性分析该院2009年7月～2010年12月14例结直肠癌合并肠梗阻急诊病例,行结肠镜与腹腔镜联合微创手术的临床资料。结果 14例患者经肠镜放置支架均成功,无穿孔发生。腹腔镜下7例行直肠癌根治术,5例行乙状结肠癌切除术,2例行左半结肠癌切除术,均行一期吻合,术后1例出现肺部感染,无吻合口漏,无伤口感染,均恢复顺利。结论结直肠癌合并肠梗阻时联合应用肠镜及腹腔镜技术进行微创手术,具有较好的临床应用价值。

Objective To explore the mini-invasive therapy for colorectal cancer with obstruction.Methods From July 2009 to December 2010,fourteen patients with colorectal cancer combined obstruction had been treated with combination of laparoscopic and enteroscopic procedures,and the data were analyzed retrospectively.Results Obstruction in all of the 14 patients were successfully resolved by enteroscopic stent placement.No major complication related to the endoscopic procedure occurred.In a week thereafter,laparoscopic one-stage procedures were performed to manage the underlying colorectal cancers,including 7 cases of rectal cancer,5 cases of sigmoid cancer,and 2 cases of descending colon cancer.All patients recovered without anastomotic leakage or wound infection.Conclusion A min-invasive treatment with colonoscopy and laparoscopy might be feasible for the emergent condition of colorectal cancer with obstruction.