腹腔镜结直肠癌切除术(附16例报告)

目的 :探讨腹腔镜结直肠癌切除术的可行性与适应证。方法 :回顾分析腹腔镜下 16例结直肠癌切除术的临床资料。结果 :按Dukes分期 :A期 3例 ,B期 9例 ,C期 4例 ;管状腺癌 9例 (中分化 5例、低分化 4例 ) ,粘液腺癌 7例 (中分化 1例、低分化 6例 )。成功 15例 ,其中腹腔镜辅助下经腹会阴联合切除术(Miles) 8例 ,1例中转剖腹行Miles术 ;全腹腔镜下直肠前切除术 (Dixon) 7例。手术时间 2 5～ 4 5h ,平均3 2h。全组无手术死亡病例 ,未发生脏器损伤。随访 5个月～ 2 5年 ,死亡 2例。结论 :腹腔镜结直肠癌手术可行 ,具有视野清 ,患者创伤小、康复快等优点 ,对全直肠系膜切除 (TME)和保肛手术更为有利 ,但应掌握手术适应证

Laparoscopic colorectomy for colorectal cancer:with a report of 16 cases

Objective:To explore the feasibility and indication of laparoscopic colorectomy in treatment of color-ectal cancer.Methods:The clinical data of sixteen patients with colorectal cancer operated by laparoscopic colorectal sur-gery were analyzed retrospectively.Results:The histological type of these patients was adenocarcinoma,and there were3in Dukes’A,9in Dukes’B,4in Dukes’C.Fifteen patients were successfully treated by laparoscopic colorectomy(8Miles,7Dixon)with no operative death and complications,one was converted to laparotomy procedures.The average oper-ation time was3.2(2.5-4.5)hours.The follow-up period ranged from5to30months,and two patients died of tumor me-tastasis.Conclusions:Laparoscopic colorectomy is clinical effective for colorectal cancer when indicated.Laparoscopic colorectal cancer resection has the advantages of minimal invasion and postoperative early resumption,especially for pa-tients who may be anus-preserved.