腹腔镜辅助下结直肠癌切除手术的临床应用.docVIP

精品论文 参考文献 腹腔镜辅助下结直肠癌切除手术的临床应用 钟宏 史勇 （深圳市龙岗区人民医院普外科 广东深圳 518172） 【摘要】目的　探讨腹腔镜辅助下结直肠癌切除手术的可行性和应用价值。方法　回顾性分析51例腹腔镜结直肠癌切除手术的临床资料。腹腔镜下完成结直肠手术49 例, 中转开腹2 例。其中右半结肠切除术10例, 左半结肠切除术10例, 乙状结肠切除术12例, 直肠前切除术11例, 腹会阴联合根治术8例。结果　全组无手术死亡。腹腔镜手术时间150 ～330 (平均200 ) min , 术中出血50 ～350(平均150) mL , 手术清除淋巴结1 ～25(平均7 ) 枚。术后24 ～72 h 均恢复胃肠功能, 术后疼痛轻, 无术中大出血、术后无特殊并发症发生。术后住院时间(不包括化疗) 7 ～11(平均9 ) d。随访42例( 82.4 % ) , 随访时间3 ～60个月, 2 例死亡, 均为Dukes C 期直肠癌患者, 1例术后15个月死于肝转移, 另1 例术后18个月死于腹腔广泛转移并衰竭。未发现套管穿刺部位及辅助小切口处肿瘤种植和局部复发。结论　腹腔镜结直肠癌手术在应用技术上可行, 且具有创伤小、痛苦少、恢复快等特点, 是治疗结直肠癌的一种微创、安全而有效的术式。 【关键词】结直肠肿瘤 外科学 腹腔镜术 【中图分类号】R730.56 【文献标识码】A 【文章编号】2095-1752（2012）18-0372-02 Clinical application of laparoscopic assisted surgery for colorectal cancer Zhong hong，Shi Yong．Longgang District Peoplersquo;s Hospital(Shenzhen 518172,China) 【Abstract】 Objective 　To explore the feasibility and value of laparoscop ic assisted surgery ( LAS ) for colorectal cancer. Methods 　The clinical data of 51 cases of LAS for colorectal cancer were reviewed retrospectively. Of them , 2 cases were converted to open operation , and in 49 cases LAS for colorectal cancer was completed. Among them , 10 cases underwent right hemicolectomy, 10 cases left hemicolectomy , 12 cases sigmoid resection , 11 cases rectal anterior resection , and 8 cases Miles operation. Results　No intraoperative deaths occurred. The average operation time was 200 ( 150 - 330 ) min with 150 ( 50 - 350 ) mL average blood loss. The average number of lymph nodes excised was 7 ( 1 - 25 ) . The time of bowel function recovery was 24 - 72 h after operation. The average hospital stay after operation was 9( 7 - 11) d. No major intraoperative blood loss nor postoperative complications were observed. The follow up time was from 3 ndash; 60 months for 42( 82. 4 % ) patients. Two cases with Duckersquo;s C rectal cancer died , one died of liver metastasis 15 months after operation , and the another died of diffuse peritoneal metas