腹腔镜手术治疗家族性腺瘤性息肉病临床分析

目的探讨家族性腺瘤性息肉病(familial adenomatous polyposis，FAP)的微创外科治疗疗效与安全。 方法回顾性分析2010年2月至2017年3月于北京协和医院行腹腔镜手术治疗的16例FAP患者的病例资料。 结果16例患者均完成腹腔镜手术，其中行全结直肠切除、回肠储袋肛管吻合术6例，全结肠直肠切除、回肠端式造口5例，全结肠切除、回肠直肠吻合术5例；无中转开腹，手术时间(227.9±52.7)min，平均术中出血量(98.1±90.7)ml。5例(31.2%)发生腺瘤癌变，4例(25.0%)伴高级别上皮内瘤变。14例患者获得长期随访，其中4例患者残余直肠新发息肉、3例患者术后发生腹腔硬纤维瘤。1例FAP合并肠癌患者术后1.5年因肝转移死亡。 结论腹腔镜手术治疗FAP安全可行；FAP患者术后需定期复查。

Laparoscopic surgery for treatment of familial adenomatous polyposis: a retrospective analysis

ObjectiveTo investigate the efficacy and safety of laparoscopic surgery for treatment of familial adenomatous polyposis (FAP). MethodsA retrospective study was conducted to collect clinical data of 16 patients with FAP undergoing laparoscopic surgery, from Feb. 2010 to Mar. 2017. ResultsAll of the 16 patients underwent laparoscopic colectomy with different anastomotic methods. The operative time was (227.9±52.7)min. Blood loss was(98.1±90.7)ml. Pathology revealed adenocarcinoma in 5 (31.2%) patients and intraepithelial neoplasia in 4 (25.0%) patients. Fourteen patients were followed up. One patient with synchronous adenocarcinoma died for hepatic metastasis 1.5 years postoperative. Four of the rest suffered adenoma recurrence and 3 patients developed desmoids. ConclusionsLaparoscopic surgery is an effective treatment for FAP. Long term follow-up is necessary for FAP patients after surgery.