直肠外翻低位直肠癌保肛切除术的技巧

目的依照直肠癌全直肠系膜切除(Total Mesorectal Excision,TME)的原则,探讨腹腔镜下直肠外翻拖出技术完成低位直肠癌骶前切除及吻合的技巧。方法选择性地对2006年6月到2010年7月间收治的56例低位直肠癌患者实施腹腔镜直肠癌根治术,术中将远端直肠经肛门外翻拖出后在直视下确定肿瘤远端切缘,完成低位保肛吻合术。结果 56例患者手术均顺利,切缘病检阴性,无吻合口漏,术后恢复顺利,随访8～60个月,35例无瘤生存。结论腹腔镜下直肠游离后,直肠经肛门外翻拖出,可以在直视下确定肿瘤远端安全切缘,可以减少术后局部复发率。

New technique for rectal eversion division in laparoscopic anterior resection

Objective We exploreed a new technique of laparoscopic-assisted anterior resection for lower rectal cancer, eversion of the rectum for tumors close to the anal verge, with transection performed under direct vision, according to the Total Mesorectal Excision （TME） principle. Methods 56 lower rectal cancer patients were selected to undergo laparoscopy-assisted anterior resection and presacral anastomosis through rectal eversion from June 2006 to July 2010 were analyzed retrospectively. Results All 56 patients underwent favora- ble procedures, obtained negative incisal margin, and smoothly rehabilitated without anastomotic leakage. The results of 8 to 60 months of follow-up indicated that the 35 patients rendered disease-free survival. Conclusion Laparoscopy-assisted radical resection and presacral anastomosis for lower rectal cancer through rectal ever- sion is a more economical and satisfactory method and ensure a negative incisal margin.