腹腔镜全直肠系膜切除术保肛治疗低位直肠癌

目的:探讨腹腔镜全直肠系膜切除术(total mesorectal excision,TME)行低位(超低位)直肠癌保肛治疗的方法与可行性。方法:按TME原则,用双吻合器技术在腹腔镜下对26例低位(超低位)直肠癌患者实行TME低位(超低位)结肠-直肠(肛管)吻合术。结果:手术均获成功,无中转开腹,手术时间180-240min,平均210min;术中出血30-100ml,平均70ml;术后2d恢复胃肠功能并下床活动;住院7-14d,平均8d,无严重并发症发生。结论:腹腔镜TME低位(超低位)吻合术保肛治疗低位直肠癌具有创伤小、并发症少、出血少、肠功能恢复快等优点,安全可行。

Laparoscopic total mesorectal excision with anal sphincter preservation in the treatment of low rectal cancer

Objective:To investigate the method and feasibility of laparoscopic total mesorectal excision(TME)with anal sphincter preservation in the treatment of low or ultra-low rectal cancer.Methods:Excision of the mesorectum and low(ultra-low)colo-rectal(anal) anastomosis were performed laparoscopically in 26 patients with low or ultra-low rectal cancer based on the concept of TME and the double stapling technique(DST).Results:TME and DST were performed successfully in 26 patients through laparoscopy.The mean operative time was 210 min(180-240 min)and the mean operative blood loss was 70ml(30-100ml).The time for bowel function recovery was about two days.The average hospitalization was 8 days(7-14 days).Complications were not observed.Conclusions:Laparoscopic TME has some advantages in the treatment of low or ultra-low rectal cancer,such as minimal invasive,less blood loss,low complication rate,and quick recovery.