腹腔镜联合结肠镜治疗结直肠良恶性肿瘤48例体会

Experience of laparoscopic and colonoscopic cooperative surgery in treatment of benign and maliganant colorectal tumours:a report of 48 cases

目的探讨腹腔镜联合结肠镜治疗结直肠良恶性肿瘤的临床疗效。方法回顾性分析我科2010年11月至2012年11月采用腹腔镜联合结肠镜治疗的48例结直肠良恶性肿瘤患者的临床资料。结果48例患者中行腹腔镜辅助结肠镜手术20例，其中5例因术中切破肠管需在腹腔镜下行修补、止血，2例因术中快速冰冻病理结果提示恶变而追加腹腔镜手术；行结肠镜辅助腹腔镜手术26例；行双镜同时治疗2例。全组均顺利完成手术，无中转开腹。术后腹腔感染2例，经保守治疗获愈。随访3～26个月，其中3例T2N0M0期肿瘤患者因出现吻合口息肉予内镜下治疗获愈，其余患者均未见肿瘤复发转移。结论腹腔镜联合结肠镜治疗结直肠较大良性肿瘤或早期恶性肿瘤具有操作容易、安全性高、痛苦轻、恢复快、并发症少等优点，值得临床推广应用。

Objective To study the application of laparoscopic and colonoscopm cooperative surgery m treatment of benign and malignant colorectal tumours. Methods A retrospective analysis of 48 patients un- dergone laparoscopic and colonoscopic cooperative surgery for colorectal tumours from November 2010 to November 2012 in our department were done. Results 20 cases undergone laparoscopy-assistant colonoscop- ic surgery, including 5 cases need laparoscopic repair and hemostasis for intraoperative rupture of intestinal tube and 2 cases need laparoscopic radical surgery for positive intraoperative quick frozen pathological re- sults. 26 cases undergone colonscopy-assistant laparoscopic surgery and 2 cases undergone combined lapa- roscopic-colonoscopic surgery. All cases had the successful completion of surgery, no transfer surgery. 2 cases had postoperative abdominal infection. Postoperative follow-up from 4~26 months, 3 cases suffered anastomotic polyps, no maliganant tumor recurrenced. Conclusion Laparoscopic and colonoscopic coopera- tive surgery can be safely performed in patients with colorectal tumors which have light trauma, less pain, few complication and rapid recovery.