腹腔镜下直肠癌全系膜切除拖出式吻合8例报告

目的探讨腹腔镜下直肠癌全系膜切除术(total mesorectal excision,TME)的优势及拖出式吻合的使用价值。方法2005年11月~2006年12月对8例直肠癌行腹腔镜下直肠癌TME,经肛门拖出切除并手工吻合。结果8例均完全在腹腔镜下完成全系膜游离后拖出肛门外切除并手工吻合,无辅助切口。手术时间180~300min,平均220min。8例随访8~18个月,平均13个月,未发现穿刺口种植和局部复发。结论腹腔镜下完成全系膜游离,清晰完整,拖出肛门外切除、吻合直观、简便、经济。

Laparoscopic Total Mesorectal Excision Combined with Pull-through Anastomosis for Rectal Cancer:Report of 8 Cases

Objective To evaluate the advantage of laparoscopic total mesorectal excision (TME) and the clinical value of pull-through anastomosis in the treatment of rectal carcinoma. Methods From November 2005 to December 2006, laparoscopic TME combined with pull-through anastomosis was carried out on 8 patients with rectal cancer. Results In all of the 8 patients, TME was completed under a laparoscope without additional incision, and the pull-through anastomosis was performed by hand.The mean operation time was 220 minutes (range, 180 to 300). The patients were followed up for 8-18 months (mean, 13 months), during which none of them developed implantation at puncture sites or local recurrence. Conclusions Laparoscopy provides a direct, magnified and reliable view for TME. Pull-though anastomosis is a convenient and low-cost method.