腹腔镜结肠直肠癌切除术15例报告

Retrospective analysis of 15 cases of laparoscopic colorectal cancer excision

目的 评价腹腔镜下结肠直肠癌切除术的可行性,提高并深入对其的认识。方法1999-2001年我院对15例患者采用了腹腔镜下结肠直肠癌切除术,对患者的病灶资料、病理学资料、手术方式及随访结果进行总结。结果 按Dukes分期,A期1例,B期12例（期2例;中分化管状腺癌3例,低分化管状腺癌2例,管状腺瘤伴灶性癌1例,高分化乳头状腺癌1例,低分化腺癌7例,中分化腺癌1例;全腹腔镜下切除8例,腹腔镜辅助下切除6例,1例中转手术;其中保肛手术5例,TME5例;无手术死亡;术后随访2年1例,1年4例,半年3例,3月内7例;死亡2例。结论 腹腔镜手术是较为成熟的技术,在结肠直肠癌切除术中具有微创外科的优点,可达到与开腹手术相同的效果,特别是TME及保肛手术更具有较突出的优势。

Objective To evaluate the feasibility and improve the recognition of the Laparoscopic colorectal cancer excision. Methods 15 patients with colorectal cancer were treated in this way in our hospital from 1999 to 2001 were analyzed. Results Based on the Dukes staging, among the 15 patients, 1 case was A, 12 were B, 2 were C; 3 cases were the medial - differentiation tubular adenocarcinoma, 2 hypo - differentiation tubular adenocarcinoma, 1 tubular adenosis with carcinomatous change, 1 hyper - differentiation papillary adenocarcinoma, 7 hypo - differentiation adenocarcinoma, and leases were medial- differentiation adenocarcinoma; 8 cases were total laparoscopic excision, 6 laparo-scopic assist excision; 5 rectal cancer excision with preservation of anus, 5 total mesorectal excision(TME). 1 Cases have been in follow- up studies for 2 years, 4 for 1 year,3 for half year and 7 for 3 month, 2 cases death. Conclusions Laparoscopic colorectal excision is an advanced technio,ue that has more advantage in the rectal cancer excision with preservation of anus and TME.