腹腔镜直肠癌根治术的应用及探讨

目的 探讨腹腔镜各种直肠癌根治术的可行性、方法以及并发症的预防。方法 自2001年9月-2003年8月，共施行了腹腔镜直肠癌根治术13例，其中Dixon手术8例，结肠肛管拖出术(改良Bacon手术)2例，Miles手术3例。结果 手术均获成功，无中转开腹。手术平均时间210min(180—240min)，术中平均出血量80ml(10—500ml)，无输尿管损伤，无吻合口瘘，住院时间10～18d。1例术后1年发现取标本切口处肿瘤种植。结论 腹腔镜直肠癌根治术有创伤小、术后肠道功能恢复早、免疫干扰轻、术后活动早、住院时间短、手术并发症少等优点。术后化疗时间亦可相应提前。有理由认为腹腔镜直肠癌根治术具有微创效果。在彻底切除肿瘤和保存功能、提高生活质量方面发展空间广阔。

Application and study of laparoscopic radical resection of rectal cancer

Objective: To investigate the mathod, possibility and how to prevent complication in radical resection of rectal cancer with laparoscopy.Methods: Thirteen cases were preformed TME with laparoscopy. Dixon 7,improved Bacon 2 and Miles 3. Results:All cases were successful. The average operative time was 210mins. The amount of bleeding during operation was between 10 and 500 ml(80 ml,ave). There was no urethra harm and stomal leak . Patients hospital stay was between 10 and 18 days. Tumor plant in incision in 1 case after 1 year.Conclusions: Laparoscopic radical resection of rectal cancer is safe and feasible.