| 经肛门切割缝合法处理远端肠管在腹腔镜超低位直肠癌保肛术中的应用 |
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| 引用本文： | 朱达坚,戎祯祥,陈小伍,剧永乐,伍锦浩,陆光生. 经肛门切割缝合法处理远端肠管在腹腔镜超低位直肠癌保肛术中的应用[J]. 中国微创外科杂志, 2008, 8(6) |
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| 作者姓名： | 朱达坚 戎祯祥 陈小伍 剧永乐 伍锦浩 陆光生 |
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| 作者单位： | 南方医科大学附属顺德第一人民医院胃肠胰疝外科,佛山,528300 |
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| 摘 要： | 目的探讨经肛门切割缝合法处理肿瘤远端肠管在腹腔镜超低位直肠癌保肛手术中的应用价值。方法2005年5月~2007年5月,对施行腹腔镜直肠癌保肛手术的11例超低位直肠癌,经肛门直视在距癌灶最下缘1cm处对肿瘤远端肠管进行缝合-切割-缝合关闭远端肠管,术中冰冻病理检查确认远端切缘无癌细胞残留,再经肛门置入管状吻合器进行肠管端端吻合。结果11例手术均获成功。手术时间115~320min,平均150min;术中出血15~75ml,平均25ml。术中无直肠破裂穿孔、输尿管及邻近器官损伤。吻合口距齿状线0.5~1cm。术后排便次数3~5次/d。术后无吻合口漏及吻合口狭窄等并发症。11例术后3个月肛门测压均正常。11例随访6~31个月,平均18.4月,未发现吻合口复发及穿刺孔、辅助小切口种植转移。结论经肛门切割缝合法处理肿瘤远端肠管在腹腔镜超低位直肠癌保肛手术中既能保证肿瘤远端肠管有足够的切除范围,又能较好地保护肛门括约肌功能。
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| 关 键 词： | 腹腔镜 超低位直肠癌 保肛手术 |
Transanal Dissection and Suture of the Distal Rectum during Laparoscopic Assisted Sphincter Preserving Operation for Ultra-Low Rectal Cancer |
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| Affiliation: | Zhu Dajian; Rong Zhenxiang; Chen Xiaowu; et al. Department of Gastroenterological; Pancreatic and Hernia Surgery; First Hospital of Shunde; Southern Medical University; Foshan 528300; China; |
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| Abstract: | Objective To evaluate the efficacy of transanal dissection and suture of the distal rectum during laparoscopic assisted sphincter preserving operation for ultra-low rectal cancer. Methods From May 2005 to May 2007, 11 patients with ultra-low rectal cancer received laparoscopic assisted sphincter preserving operation. Through the anus, the distal rectum was sutured, dissected, and closed at the level 1 cm away from the tumor. After confirming that no tumor cells existed at the margin of the resected recta se... |
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| Keywords: | Laparoscopy Ultra-low rectal cancer Sphincter preserving procedure |
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