腹腔镜联合结肠镜对结直肠息肉58例治疗效果分析

Operation via laparoscopy combined with colonoscopy for treatment of colorectal polyps in 58 cases

目的探讨腹腔镜、结肠镜联合治疗结直肠息肉的手术方法、安全性及临床效果。方法对我院2010年6月一2012年3月行腹腔镜、结肠镜联合手术切除的58例结直肠息肉患者的临床资料进行分析。结果手术均获得成功，无中转开腹。手术时间45～168（85．2±16．5）min，术中出血量15～65（33．4±8．1）ml。术后肠功能恢复时间为16～36（22．5±4．8）h，住院时间5～10（6．5±1．2）d。术后无吻合口漏、肠穿孔、肠梗阻等并发症。术后病理所见息肉直径大、绒毛管状腺瘤：多发的息肉发生癌变的概率较高。结论应用腹腔镜联合结肠镜治疗结直肠息肉的创伤小，并发症少，恢复快。对直径大、绒毛管状腺瘤、多发的息肉一经发现应尽快切除。

Objective To explore the operation methods, safety of colorectal polyps and to observe the clinical effect. Methods feasibility of laparoscopy combined with colonoscopy for treatment A total of 58 patients with colorectal polyps were treated by lapa- roscopy combined with colonoscopy. Results All the 58 cases were operated successfully without conversion to open surgery. The mean operative time was （ 85.2 ±16.5 ） min （ range 45 - 168 min） , mean intraoperative blood loss was （33.4 ± 8.1 ） ml （ range 15 -65 ml）. The mean time of gastrointestinal function recovery was （22.5± 4.8 ）h （range 16 -36 h）. The mean hospital stay was （6.5± 1.2） d （ rang 5 - 10 d）. No postoperative complications occurred. The pathological examination showed that colorectal polyps which were bigger villus-tubiform adenomas and multiple ones had higher possibility to be cancer. Conclusion Colonoscopy combined with laparoscopy is safe and feasible in the treatment of colorectal polyps. In order to prevent cancer, we should deal with the colorectal polyps as soon as possible.