腹腔镜中、下段直肠癌保肛根治术的临床分析

目的 :探讨在中、下段直肠癌保肛根治术中腹腔镜的应用、适应证及临床效果。方法 :用腹腔镜技术对 38例中、低位直肠癌患者行直肠全系膜切除 (totalmesorectalexcision ,TME)保肛根治术 ,并对手术操作、并发症的出现及术后恢复等进行临床分析。结果 :38例患者用腹腔镜技术完成手术 ,保肛率 10 0 %。手术时间 14 5 ～32 0min ,平均 16 5min ;术中出血 2 0 ～10 0ml,平均 5 0ml;术后 2 ～3d恢复胃肠功能并下床活动 ,住院时间 5 ～16d ,平均 8d。术后 8例用了止痛剂 ,无因术后并发症死亡的病例。结论 :用腹腔镜行中、低位直肠癌保肛根治术 ,不仅可达到开腹根治术的要求 ,而且具备操作安全、微创、恢复快、保肛率高的优点。

Analysis of laparoscopy keeping anus operation in middle/lower segment rectal cancer

Objective:To explore the application and effect of laparoscopic keeping anus operation in middle/lower rectal cancer.Methods:38 patients of middle/lower rectal cancer were conducted with laparoscopic total mesorectal excision of keeping anus.Operative procedures,complications and postoperative recovery were studied.Results:Laparoscopic operation succeeded in 38 patients,and no one of the cases was converted procedures.The average operation time was 165 min with 50 ml average blood loss.Gastric function recovered in all patients within 2-3 days and average 8 days were in hospital.None of the patients died due to the complications.Conclusions:Laparoscopic rectal cancer TME of keeping anus has the same effect as with the opening operation,and is well characterized for its minimal invasion,safety and quick recovery.