老年患者无气腹腹腔镜结直肠癌根治术.docVIP

精品论文 参考文献 老年患者无气腹腹腔镜结直肠癌根治术 杨娟 张居易 王继见（重庆医科大学附属第二医院普外科 400010） 【摘要】目的 探讨腹壁悬吊式无气腹腹腔镜在老年结直肠癌根治手术的可行性。方法　回顾分析39例腹壁悬吊式无气腹腹腔镜行老年结直肠癌根治手术患者的临床资料,分别记录手术时间、术中出血量、清除淋巴结数、肠管切除长度，术后腹腔引流量，术后排气时间，住院时间。结果　本组病历均获成功,手术时间( 199.5plusmn;25.6 ) min； 术中出血量（330plusmn;48）ml；术后清出肠旁及肠系膜淋巴结( 18.2 plusmn;4.6 )个；切除标本长度结肠癌为( 21.5 plusmn;2.5 )cm,直肠癌为( 19.4 plusmn;1.7 )cm；术后腹腔引流液（220plusmn;40）；肛门排气时间( 4.0plusmn;1.2 )d；住院时间（13.5plusmn;4）天，除1例术后发生切口液化延迟愈合,其余未发生吻合口瘘等严重并发症,无手术死亡。 结论　对于老年高龄高危结直肠癌患者，腹壁悬吊式无气腹腹腔镜较传统腹腔镜手术体现出更多优势，可达到结直肠癌根治性手术切除的要求，值得临床医师大力推广。 【关键词】无气腹腹腔镜 腹壁悬吊 结直肠癌 【中图分类号】R735.3+7【文献标识码】A【文章编号】1672-5085（2012）18-0072-03 Gasless Laparoscopic In Radical Surgery For Colorectal Cancer In Older Patients 【Abstract】　0bjective To explore the feasibility of Abdominal suspension of the gasless laparoscopic in radical surgery for colorectal cancer aged.Methods Retrospective analysis the clinical data of 39 aged patients use abdominal suspended gasless laparoscopic radical surgery for colorectal cancer,record the operation time,blood loss,number of lymph nodes removed,length of bowel resection,postoperative abdominal drainage,postoperative discharge time and length of stay.Results Operation time(199.5plusmn;25.6 ) min; blood loss (330plusmn;48)ml；number of lymph nodes removed (18.2plusmn;4.6)；length of intestinal canal removed (21.5plusmn;2.5)cm；discharge time after operation(4.0plusmn;1.2)days,length of stay(13.5plusmn;4)days.There were no serious complications like as anastomotic leakage except one case have wound liquefaction delayed healing,no mortality.Conclusions For the older elderly patients with colorectal cancer risk,abdominal suspended gasless laparoscopic radical surgery demonstrate the more advantages compared with the traditional celoscope surgery,it can achieve the requirements of radical surgery for colorectal cancer,and should be vigorously promoted. 【Key words】　Gasless laparoscopic Abdominal wall lifting Colorectal cancer 随着经济社会的发展，微创手术已受患者广泛关注与接受，腹腔镜因其创伤小、恢复快、住院天数短等特点，其