腹腔镜下直肠、乙状结肠癌根治术联合胆囊切除15例临床分析

Laparoscopic cholecystectomy at the time of laparoscopic proctocolectomy for colorectal cancer:a clinical analysis on 15 cases

目的探讨腹腔镜下同时行直肠、乙状结肠癌根治术及胆囊切除术的可行性及临床疗效。方法回顾性分析2014年6月至2016年6月,解放军第一〇五医院胃肠外科行腔镜下直肠、乙状结肠癌根治术中同时行胆囊切除术的15例病人临床资料。结果所有病人均顺利行腹腔镜下手术,平均手术时间为(185±25.4)min,术中出血量为(45.8±20.0)ml,淋巴结平均清扫数目为(12.5±4.5)枚,术后1~4 d排气,病人排气后即开始进食流质,平均住院时间为(11.6±5.3)d。术后随访3~26个月,无肿瘤复发及转移病人。术后有1例病人出现吻合口瘘,予以双套管冲洗后愈合。术后3例病人出现油腻饮食后饱胀不适感,均在3个月内症状缓解。结论对符合指征的病人同时行直肠、乙状结肠癌根治术及胆囊切除术是安全、可行的,在临床上值得推广。

Objective To explore the clinical value of laparoscopic cholecystectomy at the time of laparoscopic proctocolectomy for colorectal cancer.Methods The clinical data of 15 patients who underwent laparoscopic cholecystectomy at the time of laparoscopic proctocolectomy for colorectal cancer from June 2013 to June 2016 were analyzed retrospectively.Results All the patients underwent the operations successfully.The mean operation time was 185±25.4 min and mean intraoperative blood loss was 45.8±20.0 mL.The number of dissected lymph nodes was 12.5±4.5.Flatus time was 1-4 days after operation.The postoperative hospital stay was 11.6±5.3 days.There was no tumor recurrence or distant metastasis during a follow-up period of 3-26 months.Anastomotic leakage occurred in 1 case and was cured by conservative treatment.Three patients felt bloated after a heavy fatty or greasy meal,and symptoms disappeared within 3 months after operation.Conclusions Laparoscopic cholecystectomy at the time of laparoscopic proctocolectomy for colorectal cancer is a feasible procedure with minimal trauma,low morbidity and quick recovery of patients.Therefore it is worthy of clinical application.