手辅助腹腔镜手术治疗结直肠癌的临床疗效观察

Clinical outcomes of hand-assisted laparoscopic surgeries for low rectal cancer

目的探讨手助腹腔镜手术(HALS)治疗结直肠癌的临床疗效。方法收集新疆乌鲁木齐自治区人民医院肛肠外科2013年至2015年接受HALS的结直肠癌患者的完整临床资料,对HALS的成功率,长期疗效进行分析,研究该治疗方法的安全性与有效性。结果共计103例患者接受HALS术。患者平均年龄为(64±13.4)岁。男46例,女57例。体重指数(BMI)平均为(27.3±5.8)kg/m2。43例患者(41.8%)曾经进行过腹部手术。平均HALS时间为105 min(55~185 min)。中转开放率为2.7%(3/103)。胃肠功能恢复的平均时间为2.5天(2.2~4.5天)。住院时间平均为9天。术后并发症和死亡率分别为10.7%和0.97%,4例切口疝(3.9%),平均随访(7.0±3.4)个月。没有一名患者出现穿刺套部或手助装置处复发。结论 HALS结直肠切除术是一种安全有效的技术,它提供了微创手术的所有好处。

Objective To explore clinical outcomes of hand-assisted laparoscopic surgeries for colorectal cancer（HALS）. Methods Collected the clinical data of patients with colorectal cancer who received HALS from 2013 to 2015 in Xinjiang Urumqi Autonomous Region People＇s Hospital, and analysed the success rate of the technique and the long-term curative effect, the safety and effectiveness of the treatment. Results One hundred and three patients were performed HALS colorectal resections. The patients′ mean age was（64±13.4） years. There were 46 male and 57 female patients. The body mass index was（27.3±5.8） kg/m^2. Forty-three patients（41.8%） had experienced prior abdominal surgerys. The mean HALS time was 105 minutes（range, 55～185 minutes）. The conversion rate was 2.7%（3/103）.The average recovery of gastrointestinal function was 2.5 days（range, 2.2～4.5 days）. The median length of hospital stay was 9 days. The postoperative complication and mortality rates were 10.7% and 0.97%, respectively. And four incisions hernia（3.9%） were followed by an average follow-up of 7.0±3.4 months. None of the patients had a trocar or a hand-port site recurrence. Conclusion A HALS colorectal resection is a safe and effective technique, and it provides all the benefits of minimally invasive surgery.