腹腔镜辅助经肛全直肠系膜切除手术

Laparoscopic assisted transanal total mesorectal excision for low rectal cancer

男性,50岁,体重质量指数(BMI)26.7 kg/m2,初始诊断为“低位直肠癌”,肿瘤分期为cT3CN1M0;经过术前新辅助放疗后的肿瘤分期为ycT2N0M0,肿瘤下缘距离肛缘的距离为4.5 cm。患者在放疗后6周接受了腹腔镜辅助经肛全直肠系膜切除术,我们采用经腹和经肛两组手术医生团队同时实施手术,经下腹部小切口取出全直肠系膜切除的标本,在腹腔镜辅助下完成消化道重建,并采用荧光腹腔镜吲哚菁绿显像的方法检测吻合口血运。

A 50 years old male patient was initially diagnosed as low rectal cancer,with BMI of 26.7 kg/m2 and cancer staging of cT3N1M0.After preoperative neoadjuvant radiotherapy,the cancer staging was ycT2N0M0,and the distance between the lower edge of the tumor and the anal edge was 4.5 cm.Two synchronous surgical groups performed laparoscopic assisted transanal total mesorectal excision six weeks after neoadjuvant radiotherapy.The specimens of total mesorectal excision was taken out through a small incision in the lower abdomen,and the reconstruction of digestive tract was completed under the assistance of laparoscopy.The blood supply of the anastomosis was checked by using fluorescence laparoscopy with indocyanine green imaging.