无瘤技术在腹腔镜直肠癌根治术实施过程中的常见问题及对策

Problems and countermeasures of tumor-free technology in laparoscopic radical operation for colorectal cancer

目的探讨无瘤技术在腹腔镜直肠癌根治术中实施的常见问题及对策。方法选取2010年3月至2015年3月间收治的80例直肠癌患者,回顾性分析采用无瘤技术实施腹腔镜直肠癌根治术患者的临床资料。结果 80例患者中,行全直肠腹膜切除术73例,手术时间（276±45）min;行腹腔镜下经腹会阴直肠切除术7例,手术时间（198±31）min。患者术后72 h内恢复肠功能,住院1~2周后出院。术后56例获得有效随访,随访时间6~36个月,4例（7.1%）患者复发或转移,其中2例患者分别在11个月和19个月发生肝转移,1例患者7个月发生会阴部转移,1例患者5个月发生吻合复发。结论结肠癌根治术中严格遵循无瘤操作原则,可有效地降低癌细胞转移和种植风险,提高患者生活质量。

Objective To investigate the problems and countermeasures of tumor-free technology in laparoscopic radical operation for colorectal cancer. Methods From March 2010 to March 2015 in The First People＇s Hospital of Akesu District in Xinjiang,80 patients with colorectal cancer were enrolled in the study and accepted tumor-free technology. The clinical data were retrospectively analyzed. Results 73 patients underwent total mesorectal excision（ TME） and colorectal anastomosis,and the mean operative time was（ 276 ± 45） min. 7 patients underwent abdominal-perineal resection（ Miles）,and the mean operative time was（ 198 ± 31） min. The mean intestinal function recovery time was 72 h,and the hospital stays was1 ~ 2 weeks. 56 patients were discharged and followed up for 6 ~ 36 months. Local recurrence and metastasis was found in 4 cases（ 7. 1%）,including 2 cases of liver metastasis occurred in the 11 thmonth and 19 th month,1 case of perineum metastasis and 1 case of anastomosis recurrence in the 5thmonth. Conclusion Tumor-free application in laparoscopic radical resection of colorectal cancer can induce the metastasis and growing risk of cancer cells,which is effective in improving life quality of the patients.