单孔腹腔镜低位直肠癌保肛手术5例经验

目的 总结单孔腹腔镜低位直肠癌保肛手术的经验,对该技术的手术操作特点进行讨论.方法 自2010年1月至2011年10月,对5例患有低位直肠肿瘤的患者施行单孔腹腔镜直肠前切除术.手术采用脐部约3 cm切口,在腹壁深部腱膜组织上穿刺放置3枚穿刺套管,直径分别为5 mm、10 mm和12 mm,分别放置腹腔镜和两支操作钳,完全利用脐部单一通道完成手术游离操作,病灶经肛门翻转拖出切除.收集整理以上病例资料,总结手术特点.结果 5例顺利完成单孔腹腔镜直肠前切除术,手术操作时间120～250 min,术后无出血、肠梗阻和吻合口漏等并发症,手术切口无感染、裂开、疝等并发症出现.结论 通过细致的操作,单孔腹腔镜低位直肠癌保肛手术是可行的,并且具有良好的微创与美容效果.

Single incision laparoscopic sphincter-preserving operation for low rectal cancer

Objective To evaluate the operative techniques of single incision laparoscopic sphincter-preserving operation for low rectal cancer. Methods From January 2010 to October 2011, 5 patients underwent single incision laparoscopic sphincter-preserving operation for low rectal cancer at our hospital. A 3 cm trans-umbilical incision was made and 3 trocars were inserted through the aponeurosis tissue of the abdominal wall. The diameters of the trocars were 5mm,10mm and 12mm. Dissection and anastomosis were performed via the single incision. Rectal tumors were removed through the anus. The clinical data of the patients were analyzed. Results All the 5 patients underwent the single incision. The operative time ranged from 120 to 250 minutes. No bleeding, intestinal obstruction or anastomosis leakage was observed, nor incision infection, dehiscence or hernia. Conclusions Single incision laparoscopic sphincter-preserving operation has satisfactory minimally invasive and cosmetic effect.