腹腔镜下结直肠癌根治术的临床应用研究

目的:探讨腹腔镜结直肠癌根治术的临床应用价值。方法:回顾分析77例腹腔镜下结直肠癌根治术的临床病例资料,其中右半结肠切除术12例、横结肠切除术2例、左半结肠切除术12例、乙状结肠切除术8例、直肠癌行直肠前切除术19例、直肠癌行结肠拖出式切除术8例、Miles术12例、结肠次全切除术2例、全结肠切除术2例。结果:75例均在腹腔镜下完成,腹腔镜手术切除率97.4%(75/77),2例中转开腹行Miles术;手术时间平均175min;术中出血量平均110ml;术后肠蠕动恢复时间平均1.9d;术后无出血、吻合口漏、伤口感染等并发症,4例出现轻度尿潴留症状,6例术后轻度性功能障碍;术后平均住院7.5d;术后随访2~42m;死亡2人。结论:运用腹腔镜技术进行结直肠癌根治术,具有操作安全、创伤小、恢复快等特点,不仅技术上可行,而且完全可达到开腹根治术的效果。

Clinical application of laparoscopic radical resection for colorectal cancers

Objective:To study the value of laparoscopic radical colorectomy for colorectal cancer.Methods:The clinical data of 77 patients with colorectal cancer performed laparoscopic colorectomy were analyzed retrospectively;among them,12 cases performed right hemicolectomy,2 cases by transverse colorectomy,12 cases by left hemicolorectomy,8 cases by sigmoid colorectomy,19 cases by rectal anterior resection,8 cases by parks operation,12 cases by Miles operation,2 cases by subtotal colorectomy and 2 cases by total colorectomy.Results:75 cases were performed by laparoscopic colorectomy successfully,tne rate of laparoscopic excision is 97.4%,2 cases were converted to open lapotomy procedures(Miles operation);the average operative time was 175minutes;the average lose blood was 110ml;the average postoperative convalescence of intestinal peristalsis was 1.9 days;There were not operative complications such as hemorrhage,anastomostic leakage,wound infection;but 4 cases with mild retention of urine,6 cases with mild sexual dysfunction;the mean hospital stay was 7.5 days;the followup period ranged from 2 to 42 months,2 cases died of tumor metastasis.Conclusions:The laparoscopic radically colorectomy for colorectal cancer is not only technologically feasible and safe with less trauma,pain and rapid recovery,but also completely effective comparing to the open colorectomy.