36例直肠、乙状结肠癌腹腔镜手术的临床经验总结

目的：总结腹腔镜直肠、乙状结肠癌手术的临床经验。方法：回顾分析2009年2月至2009年12月为36例患者行腹腔镜直肠、乙状结肠癌手术的临床资料。结果：34例顺利完成腹腔镜手术,2例因肿瘤较大、侵犯周围脏器（膀胱或子宫）而中转开腹行Hartman手术。平均手术时间145min;术中平均出血105ml;术后2~3d胃肠功能恢复;所有标本残端均无癌细胞浸润或残留,清扫淋巴结12~29枚,平均（16.2±4.7）枚;术后发生2例吻合口瘘,1例术后早期炎性肠梗阻,无术后出血、输尿管损伤等并发症发生。术后随访所有患者均恢复良好。结论：腹腔镜结直肠手术安全可行,短期效果理想。

The summarization of clinical experience in laparoscopic operation of rectal and sigmoid colonic cancer: with a report of 36 cases

Objective:To summarize the clinical experience of laparoscopic operation for rectal and sigmoid colonic cancer.Methods:The clinical data of 36 patients with rectal and sigmoid colonic cancer who underwent laparoscopic operation was retrospectively analyzed.Results:Thirty-four cases received laparoscopic operation successfully.Two cases were converted to open Hartman surgery because of huge tumor and invasion of peripheral viscera(urinary bladder or uterus).The mean operating time was 145min,the average volume of bleeding during operation was 105ml,and the intestinal function restored within 2-3 days.No malignant cell infiltration or residual was found at stump of specimen.The number of lymph nodes scavenged was 12-29,and the mean was(16.2±4.7).Except for two cases of anastomotic leakage and one postoperative inflammatory intestinal obstruction,no other complications such as postoperative hemorrhage or ureteral injury occurred.In the follow-up,all patients recovered well.Conclusions:Laparoscopic colorectal operation is safe and feasible.Its short-term outcome is satisfied.