摘要
目的:探讨腹腔镜结肠直肠手术的手术方法、安全性、并发症及肿瘤复发等问题。方法:经腹腔镜行结肠直肠手术43例,包括右半结肠切除11例,左半结肠切除2例,乙状结肠癌根治术5例,乙状结肠癌姑息性切除术1例,乙状结肠部分切除术2例,Dixon手术15例,Miles手术7例。结果:40例成功地完成手术,3例因肿瘤侵及邻近器官或肥胖而中转开腹手术。平均手术时间为(178.5±50.7)min,结肠癌切除标本上下切缘长度分别为(12.6±2.8cm和10.2±3.4)cm;直肠癌分别为(10.2±2.6)cm和(4.3±2.2)cm,清扫淋巴结数目为(10.4±3.9)枚,其中14例有淋巴结转移。有4例(10%)术后出现并发症。术后13.2±8.1个月,根治性切除的病例平均有2例(6.4%)发生局部复发,1例(3.2%)出现肝转移,无切口和穿刺孔种植转移的发生。结论:腹腔镜结肠直肠手术在技术上是安全可行的,并能达到与开腹手术相同的疗效。
Objective To investigate the security,morbidity and incidence of cancer recurrence in laparoscopic colorectal resections. Method From March 2002 to August 2004, 43 cases of laparoscopic colorectal resection were performed in our department, including right hemicolectomy (n=ll), left hemicolectomy (n=2), radical resection of sigmoid caner (n=5), palliative resection of sigmoid cancer (n= 1), partial sigmoid resection(n=2), Dixon's procedure(n=15) and Mile's operation(n=7). Results Forty patients underwent laparoscopy successfully, 3 cases were converted to open surgery due to adiposity or advanced status of local disease. The average operative time was (178.5 ± 50.7) min (90-270) min. The length of upper and lower end of resection was (12.6±2.8) cm margius (10.2 ±3.4) cm respectively for colonic cancer. The length of upper and lower end of resection was (10.2±2.6) cm margius (4.3 ± 2.2) cm respectively for rectal cancer. The average number of lymph nodes dissected was 10.4±3.9; there were lymph node metastases in 14 cases.Complications occurred in 4 patients(10%). The local recurrence rate was 6.4%, and distant metastasis rate was 3.2%. No transplant metastasis occured in the trocar port or incision. Conclusions According to our preliminary experience, laparoscopic colorectal resection is safe and effective, it can obtain the same efficacy as in the conventional procedure.
出处
《外科理论与实践》
2004年第6期467-469,共3页
Journal of Surgery Concepts & Practice
关键词
腹腔镜
结肠直肠肿瘤
根治
Laparoscopy
Colorectal tumor
Radical resection
