腹腔镜低位直肠癌根治51例

目的探讨腹腔镜全直肠系膜切除（TME）治疗低位直肠癌的临床应用。方法回顾性分析51例腹腔镜低位直肠癌手术，其中Dixon术式42例，Miles手术9例。结果51例手术成功，无中转开腹，平均耗时150min，术中平均失血100mL，术后平均住院9d，无术后出血、吻合口瘘、4例排尿障碍，5例出现明显性功能障碍。随访1—39个月，随访率为80％，2例腹腔广泛转移，2例肝脏转移，1例穿刺口转移。结论腹腔镜下TME治疗低住直肠癌安全可行，且创伤小，疼痛轻，恢复快。良好的腹腔镜手术技术和手术适应证以及丰富的开腹直肠手术经验是手术成功的保证。

Report of 51 cases of laparoscopic radical surgery for low rectal cancer

Objective] To study the clinical application of total mesorectal excision to low rectal cancer. Methods] 51 cases with low rectal cancer underwent laparoscopic total mesorectal excision (TME) were reviewed. 42cases underwent rectal anterior resection, and 9 cases underwent abdominal perineal resection. Results] All operation succeeded. The mean time of operation was 150 mins, average intraoperative bleeding was 100 mL, the mean postoperative hospital stay was 9 days. 5 cases arised sex dysfunction. 4 cases urinary retention no other postoperative complication such as bleeding and leakage occurred. 80% patients were followed up 1~39 months, 2 cases metastasize in liver and another 2 cases in abdominal cavity, and 1 case was found trocar sites implantation. Conclusion] The laparoscopic total mesorectal excision for low rectal cancer is both feasible and safe, and with less trauma, pain and rapid recovery. It must be performed under the good indication by skilled and experienced surgeons.