摘要
目的 探讨腹腔镜下完成全直肠系膜切除 (TME)、低位 /超低位 /行结肠 -肛管吻合治疗低位直肠癌的可行性。 方法 按TME原则 ,在腹腔镜下对 4 2例低位直肠癌患者实施低位 /超低位 /结-肛吻合术。 结果 4 2例腹腔镜TME、低位 /超低位 /结肠 -肛管吻合术均获成功 ,保肛率 10 0 %。手术时间 (110～ 2 10 )分钟 ,平均 12 5分钟 ;术中出血 (5～ 80 )ml,平均 2 0ml;术后 1～ 2天恢复胃肠功能并下床活动 ,住院时间 (5～ 14 )天 ,平均 8天。术后 18例应用了止痛剂 ,术中及术后均无并发症发生。 结论 腹腔镜下行TME低位 /超低位结肠 -肛管吻合术治疗低位直肠癌可行。具有创伤小、出血少、保肛率高、术后疼痛轻、恢复快等优点外 ,对自主神经丛的保护更准确 ,术后肛门括约肌功能。
Objective To assess the feasibility of laparoscopic total mesorectal excision (TME) and the preservation of sphincter function for the treatment of patients with low rectal cancer. Methods 42 patients with low rectal cancer underwent laparoscopic total mesorectal excision (TME) combined with low/ultralow/colo-anal anastomosis. Results 42 cases were successfully completed and no one was converted to open laporotomy.A mean operation time was 125min(110min～210min) while a mean blood loss was 20ml(5ml～8ml).The time of returned bowel function and postoperative died was (1-2)days after the operation. 18 patients required postoperative analgesic.The average hospitalized day was 8 days (5d～14d) No intraoperative and postoperative complications occurred in all 42 patients. Conclusions The laparoscopical total mesorectal excision and low/ultralow colo-anal anastomosis in the treatment of rectal cancer is feasible and has the advantages of safe, effective, dramatically more accurate autonomic nerve preservation, higher retes of sphincter presesrvation and better micturition with decreased postoperative pain and quicker recovery.
出处
《中国微创外科杂志》
CSCD
2002年第2期85-87,共3页
Chinese Journal of Minimally Invasive Surgery
基金
国家杰出青年基金资助项目 (批准号 :3 992 5 0 3 2 )
