摘要
目的评价腹腔镜直肠癌根治手术效果，总结手术体会。方法对38例腹腔镜直肠癌根治手术病例资料进行回顾性研究。对手术过程、肿瘤根性切除情况、术后恢复情况、术后并发症进行分析，评价手术安全性、TME切除及肿瘤根治切除效果。并对腹腔镜直肠癌根治手术的若干体会进行讨论。结果38例腹腔镜直肠癌根治手术均获得成功。手术时间平均216．32分钟，术中失血量平均120．0毫升。切除直肠标本远近切缘均未见癌残留，淋巴结清扫数目平均18．21枚，直肠切缘至肿物下缘距离平均2．45cm，直肠系膜切缘距肿物下缘距离平均4．23cm。下床活动时间平均1．84天、胃肠功能恢复时间平均2．40天、住院时间平均11．34天。术后并发症共5例，经相应治疗后均痊愈。结论腹腔镜手术是微创、安全、有效的直肠癌根治手术，具有良好的根治效果，符合TME要求。熟悉盆腔的解剖，掌握适当的手术技巧有助于手术的顺利进行。
Objective To evaluate the effect and to summary the experience of laparoseopic radical operation for rectal carcinoma operation. Methods A retrospective study was adopted to analyze of 38 cases laparoseopic radical operation for rectal career. The operation process and root excision tumor and postoperative recovery and postoperative eomplicatians were analyzed. The operation safety and TME resection and tumor radical effect were evaluated. The experience of laparoseopie radical operation for rectal carcinoma is discussed. Results 38 eases of laparoseopie radical rectal cancer operation were successful. Operation time was 216.32 minutes, intraoperative blood loss averaged 120 ml. Resection of the rectum specimens margin showed no residual carcinoma, the number of dissected lymph node average 18.21 and the distance of rectal resection margin to tumor margin distance average 2.45cm and the distance of mesoreetal margin from tumor margin distance average 4.23cm. Bed activity time averaged 1.84 days, recovery of gastrointestinal function in a mean time of 2.40 days, hospital stay averaged 11.34 days. There were 5 cases of postoperative complications and all of that were cured by corresponding treatment. Conclusions Laparoseopie radical resection of rectal carcinoma is minimally invasive, safe, effective and has a good curative effeet and meet the requirements of TME. Familiar with pelvic anatomy, master proper operation technique facilitates the operation smoothly.
