腹腔镜结直肠癌根治术37例临床疗效观察

Clinical observation on the effect of laparoscopic radical resection of colorectal cancer in 37cases

目的探讨腹腔镜结直肠癌根治术的可行性、安全性及临床疗效。方法将收治的37例结直肠癌患者行四孔法腹腔镜结直肠癌根治术,根据肿瘤部位的不同,分别行左半结肠切除、右半结肠切除、乙状结肠切除、低位前切除术(Dixon)及腹会阴联合切除术(Miles)。结果本组37例患者除1例中转开腹手术外,其余36例均在腹腔镜下顺利完成结直肠癌根治术,手术时间平均175min;术中出血量平均160ml;肠功能恢复时间平均20h。术后住院时间为平均10d。术后无出血、吻合口瘘、切口感染等并发症发生,无手术死亡病例。有18例患者于术后第2周接受为期4～10周的FOLFOX4方案化疗,其中4例同时接受术后辅助放疗。随访3～18个月,平均9个月,1例患者于术后13个月复发并肝转移,其余患者均未发生复发、转移、切口种植等并发症。结论腹腔镜结直肠癌根治术具有手术视野清晰、患者痛苦少、恢复快、住院时间短、并发症少等优点,术中严格遵守结直肠癌根治原则和无瘤操作原则,完全可达到根治目的,是安全可行的。

Objective To discuss the the feasibility,safety and clinical efficacy of laparoscopic radical resection on colorectal cancer.Methods From July 2009to September 2012,37cases of patients with colorectal cancer underwent laparoscopic resection.Depending on the tumor site,line left hemicolectomy,right hemicolectomy,right hemicolectomy,sigmoid resection,Dixon surgery and Miles operation were applied.Results 37patients except 1were converted to open surgery,and the remaining 36cases were successfully completed laparoscopically resection of colorectal cancer.The mean operation time was 175min;average blood loss was 160mL;intestinal function recovery time was 20h.Postoperative hospital stay was average 10d.There was no bleeding,anastomotic leakage,wound infection and other complications postoperation,no operative deaths.Conclusion Laparoscopic resection of colorectal cancer patients with less pain,quicker recovery,Shorter hospital stay,fewer complications.Intraoperative strict compliance with the principle of colorectal cancer and tumor-free operation principle,fully achieve radical purposes,it is safe and feasible.