腹腔镜下双入路直肠癌根治术53例体会

Laparoscopic double approach radical resection of rectal cancer in 53 cases

目的探讨直肠癌根治术中腹腔镜下双入路法的临床价值。方法回顾性分析2019年5月至2020年5月本院收治的53例直肠癌患者的临床资料,所有患者均采用腹腔镜双入路根治术治疗,分析手术情况、术后并发症及随访情况。结果53例患者临床手术均成功,未损害胰腺等相关组织,未发生中转开腹术情况。53例患者住院时间(12.5±3.5)d,术后排气时间(3.3±1.5)d,淋巴结清除数量(12.5±4.5)枚,下切缘与肿瘤相距(4.8±2.2)cm,切除长度(20.8±5.3)cm,术中出血量(85.3±24.2)ml,手术时间(162.5±34.3)min。术后并发症发生率为13.2%,包括吻合口瘘1例(1.89%),肺部感染2例(3.77%),尿潴留1例(1.88%),切口感染3例(5.66%)。所有患者均未出现肿瘤复发情况。结论采用腹腔镜下双入路根治术治疗直肠癌时病理解剖层次清晰,径路准确,具有良好的应用价值。

Objective In colorectal cancer radical the value of laparoscopic double approach and experience and clinical practice to be analyzed.Methods The clinical data of 53 patients with rectal cancer admitted in our hospital from May 2019 to May 2020 were analyzed retrospectively,and all patients were treated with laparoscopic doubleapproach radical resection,and the surgical conditions,postoperative complications and follow-up were analyzed.Results All 53 patients underwent successful clinical operations without damage to the pancreas and other related tissues,and no conversion to laparotomy occurred.the hospital of time was(12.5±3.5)d,the postoperative exhaust time was(3.3±1.5)d,the number of lymph nodes was(12.5±4.5),the distance between the lower margin and the tumor was(4.8±2.2)cm,the resection length was(20.8±5.3)cm,the amount of intraoperative bleeding was(85.3±24.2)ml,and the operation time was(162.5±34.3)min.The incidence of postoperative complications was 13.2%,including anastomotic leakage in 1 case(1.89%),pulmonary infection in 2 cases(3.77%),urinary retention in 1 case(1.88%),and incision infection in 3 cases(5.66%).No tumor recurrence occurred in all patients.Conclusion Laparoscopic double approach radical resection for the treatment of rectal cancer has clear pathological anatomy hierarchy and accurate approach,which has good application value.