高频电刀精准高热直肠癌切除技术临床研究.docVIP

高频电刀精准高热直肠癌切除技术临床研究 ? 842?山西医型大学学报(JShanxiMedUniv)2021年10月,42(10 高频电刀精准高热直肠癌切除技术临床研究 王红军(西安交通大学医学院第一附属医院普外科,西安710061) 摘要:目的总结和介绍高频电刀在中,低位直肠癌全系膜根治性切除术(totalmesorectalexcision,TME)中的临床效果及使 用技巧.方法回忆性分析西安交通大学医学院第一附属医院2005—01—2021—06间,连续采用美国威力Ⅱ型高频电刀 行中低位直肠癌根治术(TME)219例患者的临床资料.结果本组资料清扫淋巴结数量(31.5±9.5)个,与NCCN直肠癌 手术的12枚淋巴结标准相比淋巴结去除数增加;手术时间(90.5±15.0)min;术中出血(60±15)ml,手术视野清晰.166例前 切除(anteriorresection,AR),低位保肛手术(1owanteriorresection,LAR),术后无吻合口漏及出血发生;53例腹会阴切除(ab. dominoperinealresection,APR),无术后会阴部切口感染发生.全组患者术后无盆腔出血,淋巴漏及围手术期手术死亡.结 论中低位直肠癌根治术中采用高频电刀技术提高了淋巴结清扫的彻底性,高频电刀环周热灼,热辐射作用降低了手术创面 癌残留时机,确保了直肠癌根治的效果. 关键词:直肠肿瘤;根治性切除;高频电刀;高热无瘤技术 中图分类号:R735.37文献标志码:A文章编号:1007—6611(2021)10—0842—03DOI:10.3969/J.ISSN.1007—6611.2021.10.019 Studyonsurgicalskillsofhighfrequencyelectroscapelinrectalcarcinomaresection WANGHong-jun(DeptofGeneralSurgery,FirstAffiliatedHospitalofMedicalCollege,Xi’anJiaotongUniversity,Xi’an710061,Chi— na) Abstract:oRctiveTosummarizeandintroducetheclinicalefficacyandSUrgicalskillsofhigh—frequencyelectroscapelintotalme— sorectalexcision(TME)ofthemiddleandlowerrectalcancer.MethodsValleyⅡhigh—frequencyelectroscapelwasusedtotreat 219patientswithlowrectalcancerfromJanuary2005toJune2021inFirstAffiliatedHospitalofMedicalCollege,Xi’anJiaotongUni- versity.Theclinicaldataof219patientswereretrospectivelyanalyzed.ResultsTheaveragenumberofremovedlymphnodewas 31.5±9.5for219patientswithlowrectalcancer.higherthanthetraditionalstandardofNCCNsurgeryof12lymphnodes.Themean operativetimewas(90.5±15.0)min,andtheoperativebleedingvolumewas(60±15)m1.Thesurgeryvisionwasclear.Of166ca— sesofanteriorresectionorlowanteriorresection,nopostoperativeanastomoticleakageandbleedingoccurred.Of53casesofabdomino— perinealresection,nopostoperativeperinealincisioninfectionhappened.Allpatientshadnopelvicbleeding,lymphleakageandperiop— erativesurgicalmortality.ConclusionThehighfrequencyelectroscapelcouldimprovethetumor?freesurgicalmarginoflymphade— nectomy.Itissafeincurativeproctectomyforpatientswithrectalcarcinoma