腹腔镜下左半结肠切除术56例临床分析.docxVIP

腹腔镜下左半结肠切除术56例临床分析 作者：丁卫星 邓建中 程龙庆 杨平 梁毅超　  【摘要】 目的 探讨腹腔镜下左半结肠切除术的安全性和可行性。 方法 对56例腹腔镜下左半结肠切除术患者的临床资料和随访情况进行回顾性 分析 。结果4例手术在腹腔镜下顺利完成，中转开腹2例、中转率%(2/56)，无手术死亡。平均手术时间(168±42)min，平均出血量(75±45)ml，辅助切口平均长(6±)cm，术后平均住院日(9±3)d。手术并发症发生率%(2/54)，其中术后肠梗阻1例(发生率%、1/54)、肺炎1例(发生率%、1/54)。54例患者术后随访3～63个月，3例远处癌转移(复发率%、3/52)，2例死亡，全组患者的腹壁穿刺孔及辅助小切口无肿瘤种植。结论 腹腔镜下左半结肠切除术是安全可行的，手术近期疗效令人满意，长期结果有待进一步观察。  【关键词】 腹腔镜； 左半结肠切除术； 结肠肿瘤  【Abstract】 Objective To evaluate the feasibility and safety of laparoscopicassisted left hemicolectomy. Methods A retrospective study was done on clinical data and followup ofcases treated with laparoscopeassisted left hemicolectomy from January00to December006. Results Left hemicolons ofcases were dissected and separated from the abdominal wall using laparoscopic instruments. The n, the resection of the left hemicolon and anastomosis were dealt with a small assisted incision extracorporeally. No intraoperative death occurred but two cases were converted to laparotomy, with conversion rate % (2/56). The mean operation time, blood loss, assisted incision length, postoperative hospital stay were (168±42) min, (75±45) ml, (6±) cm, (9±3) days, respectively. The operative complications included one patient with intestinal obstruction (%, 1/54) and one with postoperative pneumonia (%, 1/54). The overall morbidity % (2/54). All patients were followed up for tomonths. Distant metastases were found in cases (%,/52), and death in. No carcinoma was implanted in the trocar holes and the assisted incisions in all the patients. Conclusions Laparocopeassisted left hemicolectomy is feasible and safe and has a favorable shortterm outcome. Its long term outcome needs further investigation.  【Key words】 Laparoscope; Colon tumor; Left hemicolectomy  自1991年Jacobs等［1］报道第1例腹腔镜结肠切除术后，经过10余年的 发展 ，腹腔镜技术已 应用 到结直肠外科的各种术式，特别是“微创外科”新概念［2］的深入人心，国内开展此类手术的 医院 也越来越多。我院胃肠外科自XX年1月至XX年12月，共施行腹腔镜下左半结肠切除术56例， 现报道如下。  1 资料和方法  一般资料  本组