摘要
目的 :探索腹腔镜全直肠系膜切除 (TME)与低位 /超低位结直肠吻合保肛门术治疗中下段直肠癌的可行性、方法与优缺点。方法 :按开放手术的TME切除原则、应用双钉合技术 ,在腹腔镜下对 12例肿瘤下缘距离肛缘 3～ 10cm的中下段直肠癌患者实施了TME与低位 /超低位结直肠吻合保肛手术 ,1例切除部分受侵犯的阴道后壁 ,1例同时行了结肠J型贮袋直肠吻合术。结果 12例患者手术顺利 ,无中转开腹 ,手术时间 190 (16 0～ 2 30 )min ;术中出血 2 0 (10～ 10 0 )ml,术后 1～ 2d恢复胃肠功能并进食流质、下床活动 ,术后住院时间 10 (6～18)d。术中术后无并发症发生。结论 :腹腔镜TME与低位 /超低位结直肠吻合保肛术治疗中下段直肠癌安全可行 ,具有创伤小、手术视野清楚、出血少、术后疼痛轻恢复快等优点。
Objective:To assess the feasibility and adequacy of laparoscopic total mesorectal excision (TME) and low/ultralow colo-rectal anastomoses for rectal cancar.Method:Excision of the mesorectum and low /ultralow site anastomoses were performed laparoscopically on 12 patients with med/low rectal cancer based on the concept of TME and double stapling technique (DST) from March 2000.Results:Laparcoscopic TME and DST were completed successfully,no one was converted to open procedures.The average operation time was 190 (160～230)min.The blood loss in operation was 20(10～100)ml.The time of bowel function returned and the time to resume post-operatively diet was 1～2 days after the operation.Average hospital stay after operation was 10 (6～18)days and there were no intraoperative and postoperative complications in all 12 patients.Conclusions:Based on these preliminary results,we believe that laparoscopic TME and low/ultralow colo-rectal anastomoses for med/low rectal cancer is a perspective minimally invasive technique,which can be carried out safely and effectively with decreased postoperative pain and dramatically higher rates of sphincter perservation.
出处
《中国内镜杂志》
CSCD
2001年第6期11-13,共3页
China Journal of Endoscopy
关键词
腹腔镜
全直肠系膜切除术
直肠癌
外科手术
Laparoscopic
Total Mesorectal Excision
Rectal Cancer
Surgery Operation
