腹腔镜辅助经尾骶入路低位直肠癌切除吻合术的治疗效果分析陈彻.DOC

PAGE \* MERGEFORMAT 3 腹腔镜辅助经尾骶入路低位直肠癌切除吻合术的治疗效果分析 陈彻 ，吴晓宇※，姚学权*，刘福坤，周亮，陈志伟，曹勤洪，孙正，姜超 南京中医药大学附属江苏省中医院肿瘤外科 摘要 目的 探讨腹腔镜辅助经骶尾部入路行直肠癌超低位切除，保留肛门的新手术方式可行性。方法 2010年1月至2012年6月低位直肠癌患者15例，采用腹腔镜辅助经骶尾入路行超低位切除吻合术。结果 无手术死亡，平均手术时间120分钟，出血量：腹腔镜手术组，失血量平均为20ml，骶尾部手术组，失血量平均为80ml，手术后一周发生吻合口漏2例，行术后横结肠造口后康复出院。随访1～20月无局部复发和远处转移。结论 腹腔镜辅助经骶尾部入路超低位直肠癌切除术，作为一种新手术方式，可以用于传统手术时无法保留肛门的超低位直肠癌病人。 关键词： 低位直肠癌； 腹腔镜；直肠癌切除术；经骶尾部入路 ※：共同第一作者 *：通讯作者 Effects of laparoscopically assisted transsacral resection of ultra-low rectal cancer with primary anastomosis Chen Che, Wu Xiaoyu※, Yao Xuequan*, Liu Fukun, Zhou Liang, Chen Zhiwei, Cao Qinhong, Sun Zheng, Jiang Cao Department of Surgical Oncology, The First Affiliated Hospital of Nanjing University of Chinese Medicine Abstract Objective: To explore the feasibility of retaining anal by laparoscopically assisted transsacral resection of ultra-low rectal cancer. Methods: 15 patients who presented with ultra-low rectal cancer, underwent laparoscopically assisted transsacral resection of ultra-low rectal cancer with primary anastomosis between 2010 January and 2012 June. Results: No perioperative deaths occurred. Mean operative time was 120 minutes. Amount of bleeding: average blood loss was 20 ml in laparoscopic operation group, and 80 ml in assisted transsacral resection group. 2 patients of anastomotic leakage occurred in one week after the operation, and rehabilitated after transverse colostomy. Late follow-up evaluation ranged from 1 to 20 months, both of these patients have no local recurrence and distant metastasis. Conclusions: Laparoscopically assisted transsacral resection of ultra-low rectal cancer with primary anastomosis as a new modus operandi can be used in patients who presented with ultra-low rectal cancer that traditional operation cannot retain anal. Key words: ultra-low rectal cancer, Laparoscopically, assisted transsacral resection ※Co-first author: Wu Xiaoyu * Corresponding author: Yao Xuequan 腹腔镜辅助经尾骶入路低位直肠癌切除吻合术的治疗效果分析 低位直肠癌的保肛手术一直是手术的难