低位或超低位直肠癌腹腔镜下经肛门外翻拖出切除吻合术的临床体会

Clinical Experience of Laparoscopic Resection and Resection of Low or Ultra-low Rectal Cancer by Transanal Eversion

目的低位或超低位直肠癌腹腔镜下经肛门外翻拖出切除吻合术的临床体会。方法回顾性总结于2013年3月—2015年12月就诊于我院胃肠外科65例实施腹腔镜直肠癌根治术患者,有选择性的对其中13例实施该术式,分析资料,总结意义。结果 13例患者均顺利完成手术,无一例中转开腹,手术时间(160.0±25.0)min,术中出血量(60.0±15.0)ml,胃肠功能恢复时间36~78 h,平均(52.0±16.0)h,术后5~6天后开放流质饮食;住院时间(10.0±1.5)天,术后均未出现吻合口漏、出血等不良并发症;术后排便功能经过一段时间锻炼恢复或接近正常;分别于术后3、6、9、12个月随访,均未出现远处复发及转移迹象。结论低位或超低位直肠癌腹腔镜下经肛门外翻拖出切除吻合术安全、可行,疗效满意。

Objective Clinical experience of laparoscopic resection and resection of low or ultra-low rectal cancer by transanal eversion. MethodsRetrospective review was performed in 65 cases of laparoscopic radical resection of rectal cancer in our hospital from March 2013 to December 2015. 13 cases were selected and analyzed. The data were analyzed and summarized. Results 13 patients were successfully completed surgery, no cases were converted to laparotomy. The operation time（160.0±25.0） min, the amount of bleeding（60.0±15.0） ml, gastrointestinal function recovery time was 36 to 78 h, the average（52.0±16.0） h, after 5 to 6 days after the opening of the liquid diet; Hospitalization time（10.0±1.5） days, no postoperative anastomotic leakage, bleeding and other adversecomplications, postoperative defecation function after a period of exercise, recovery or near normal; After 3, 6, 9, 12 months follow-up, there were no distant recurrence or metastasis. Conclusion Laparoscopic transanal pull through resection and anastomosis for low or ultra-low rectal cancer is safe, feasible and satisfactory.