摘要
目的探讨腹腔镜超低位直肠癌保肛手术的可行性、安全性、操作要点和治疗效果。方法回顾性分析68例患者行腹腔镜超低位直肠癌保肛手术的临床病例资料。结果 68例超低位直肠癌患者均成功行腹腔镜直肠癌超低位保肛手术,手术时间(152.45±11.56)min,手术切除淋巴结5～27枚,肿瘤下缘距远切端(2.2±1.0)cm,47例患者(69.1%)行回肠预造瘘。术后总并发症率17.6%(12/68),包括吻合口漏5例(7.4%),均为未行预造瘘患者(其中1例死亡);右侧输尿管损伤1例(1.5%);尿潴留2例(2.9%);泌尿系感染3例(4.4%);Tocar孔感染1例(1.5%),均经保守治疗后治愈。结论腹腔镜超低位直肠癌保肛手术是可行的、安全的,预防性末端回肠造瘘可明显降低吻合口漏的风险,增加手术的安全性。
Objective To investigate the feasibility, safety, operating essentials and therapeutic effect of laparoscopic resection of super-lower rectal cancer with sphincter preservation. Methods Clinical data of 68 patients with super-lower rectal cancer from our center were retrospectively analyzed. Results All of the 68 patients received successful laparoscopic rectectomy with sphincter preservation. The operation time was （152.45 ＋_ 11.56） minutes. Five to twenty-seven lymph nodes were harvested. The distance between tumor to the distant margin was （2.2 ± 1.0）cm. Ileostomy was performed in 47 （69.1% ） patients. Twelve （17.6%） patients suffered from postoperative complications, including anastomic leakage in 5 patients without protective stoma （7. 4% ） （with 1 postoperative death）, right urethral injury in 1（1.5% ）, uroschesis in 2 （2.9%） , urinary infection in 3 （4.4%） and troear hole infection in 1 （ 1. 5% ）. All complications were cured by conservative treatment. Conclusion Laparoscopic resection of super-lower rectal cancer with sphincter preservation is safe and feasible. Protective ileostomy could significantly reduce the incidence of anastomic leakage with increased security.
出处
《中华普外科手术学杂志（电子版）》
2013年第2期22-24,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
