腹腔镜辅助直肠前切除术后肠梗阻的分析及预防（附100例报告）

目的探讨腹腔镜辅助直肠前切除术后肠梗阻发生的主要危险因素和预防方法。方法分析100例腹腔镜辅助直肠前切除术患者的临床资料,所有病例术前无急性肠梗阻、穿孔或出血等需行急诊手术,无腹腔内广泛转移,无肺、脑或骨转移,无手术危险程度ASA（美国麻醉师协会评分）≥Ⅳ、Ⅴ级。肿瘤下缘距肛缘距离为4～20 cm,平均（8.26±3.3）cm。所有临床资料经SPSS 13.0 for windows软件包处理后用卡方检验进行统计学分析。结果 100例中无中转开腹,其中术后肠梗阻5例（发生率为5%）,发生于术后第4-13天。其中3例经保守治疗治愈。结论只要围手术期处置得当,腹腔镜手术不会增加术后肠梗阻的发生率。

Analysis and prevention of ileus after laparoscopic anterior resection for rectal cancer

Objective To review the incidence of ileus after laparoscopic anterior resection for rectal cancer.Methods The clinic data of 100 patients,including 64 males and 36 females aged 29~81 y(58.5±12.1)y,who underwent laparoscopic anterior rectal resection for rectal cancer from September 2005 to January 2009 were retrospectively analyzed.Distance from tumor to anal was from 4 to 20 cm with the mean of(8.26±3.3)cm.Patients with following conditions were excluded in the analysis: acute intestinal obstruction,intra-abdominal spread,lungs/brain/bone metastases and ASA(American Society of Anesthesiologists) risk scores ≥Ⅳ and Ⅴ.The data were analyzed by SPSS 13.0.Results In this group of patients,no case was converted to open surgery,ileus occurred in 5 patients(5%) at the 4 to 13 days after operation.The five patients were cured by conservative treatment.Conclusion The data indicate that laparoscopic anterior resection for rectal cancer does not increase the risk of ileus.