直肠癌腹腔镜肛提肌外腹会阴切除术的体位护理配合的探讨

Laparoscopic Colorectal Cancer Discussed outside the Extralevator Abdominoperineal Excision with the Postural Care

目的:探讨腹腔镜辅助直肠癌柱状/肛提肌外腹会阴切除术(ELAPE)的体位护理配合方式。方法:2008年1月至2013年4月,我院对35例进展期低位直肠癌患者施行了腹腔镜辅助直肠癌ELAPE。其中男性18例,女性17例,平均年龄67岁。肿瘤距离肛缘平均3.8cm。术前经MRI检查分期,T3期19例,T4期16例。35例患者先采取平卧分腿位在腹腔镜下游离病变肠管再俯卧折刀位经骶尾部行直肠癌根治术,术中采用变换体位护理配合。结果:术中变换体位护理配合,使35例手术均顺利完成,无压疮、感染等并发症的发生。结论:充分的体位准备,熟练的术中配合及病情观察,合理的体位摆放和转换是保证腹腔镜辅助直肠癌柱状/ELAPE顺利进行的关键。

Objective： Laparoscopic assisted colorectal cancer columnar/Extra-levator Abdominoperineal Excision（ELAPE） outside the nursing position with the way. Methods：January 2008 to April 2013, our hospital patients with advanced colorectal cancer in 35 patients of low colorectal cancer underwent laparoscopic-assisted ELAPE. Of which 18 males and 17 females, with an average age of 67 years. Tumor from the anal verge average 3.8cm. Preoperative staging by MRI, T3 of 19 cases, T4 of 16 cases. 35 patients taking ifrst place in the supine straddle free laparoscopic bowel disease prone jackknife position again sacral line colorectal cancer after radical surgery, intraoperative care with the use of changing position.Results：Intraoperative care with changing position, so that 35 cases were successfully completed surgery without pressure sores, infection and other complications.Conclusions：Position fully prepared, skilled surgery with and observe the condition, reasonable body position and muscle conversion is the key to ensuring a smooth outer ELAPE performed laparoscopically assisted colorectal cancer columnar.