腹腔镜在结直肠癌手术中的临床应用.docVIP

精品论文 参考文献 腹腔镜在结直肠癌手术中的临床应用 江苏大学附属武进医院普外科 江苏常州 213002 摘要：目的 探讨腹腔镜在结直肠癌手术中的临床应用。方法 回顾性分析2009年1月—2014年9月完成腹腔镜下结直肠癌手术146例患者临床资料，其中行右半结肠根治性切除术18例，乙状结肠根治性切除12例，直肠癌行Dixon术66例，Milersquo;s术50例。结果 146例均完成腹腔镜手术，无死亡病例，全部病例均治愈出院。术后无出血、吻合口漏、伤口感染等并发症，手术后恢复蠕动时间16-70h，手术时间165～270min，平均190min，术中出血80～300ml，平均126ml，术后随访10～26个月，未见肿瘤转移、局部复发、Trocar及小切口种植。结论 运用腹腔镜技术进行结直肠癌根治术，具有操作安全、创伤小、恢复快等特点，不仅技术上可行，而且完全可达到开腹根治术的效果。 关键词：腹腔镜；结直肠癌；手术 Abstract：Objective To explore the clinical feasibility of laparoscopic colorectal surgery.Methods The clinical data and following-up records of 146 cases colorecta1 cancer patients who had received laparoscopic colorectal surgery from January 2009 to September 2014 were retrospectively analyzed，including 18 cases right hemicolectomy，12 cases sigmoid operation，66 cases Dixons operation，50 cases Miless operation.Results All the 146 patients were successfully performed laparoscopic surgery for colorectal cancer．None had been changed to opening operation and no death case．No complications such as abdominal infections，anastomosis leakage，bleeding or other severe complications were found.the intestinal function restoring time was 16-70h；operation time was 165-270 min（mean，190min）；blood loss was 80-130ml（mean，126ml）；With a 10 to 26 months follow-up，no recurrence，distant metastasis or copracrasia was observed.Conclusion The laparoscopic colorectal surgery has the advantages of safety，faster recovery，less trauma，complications and blood loss.Its effect was as good as that of open radical surgery in the treatment of colorectal cancer and was worth further clinical application． Key words：Colorectal cancer；Laparoscopy；Operation 腹腔镜结直肠手术具有创伤小、术后肠道功能恢复快、住院时间短、疤痕小等特点。结直肠癌目前最佳的治疗手段仍是外科手术，治疗原则为切除肿瘤、改善生活质量[1-2]。结直肠癌如不及时治疗，极大地威胁患者的身体健康，腹腔镜结直肠癌手术的目的是为了在获得与开腹手术相同的治疗效果的基础上减少手术本身的创伤，缩短术后恢复时间。本文选取我院自2009年1月-2014年9月共进行146例腹腔镜结直肠癌切除手术，效果满意，现报告如下。 1资料与方法 1.1一般资料 本组男91例，女55例；年龄47～89（平均65）岁。入院时均有黏液血便、排便不尽感、腹疼等症状1个月至1年。术前均经电子结肠镜及病理检查确