腹腔镜DST、低位/超低位/结-肛吻合术治疗低位直肠癌

目的　探索腹腔镜双钉合技术 (double stapling technique,DST)与低位 /超低位 /结 -肛吻合术治疗低位直肠癌的可行性。方法　用 DST在腹腔镜下对 30例低位直肠癌患者实施低位 /超低位 /结 -肛吻合术。结果　 30例腹腔镜 DST与低位 /超低位 /结 -肛吻合术均获成功 ,保肛率 10 0 %。手术时间 115～ 32 0分钟 ,平均 15 5分钟 ;术中出血 5～ 80 m l,平均 2 0 ml;术后 1～ 2天恢复胃肠功能并下床活动 ,住院时间 5～ 14天 ,平均 8天。术后仅 14例患者应用了止痛剂 ,术中及术后均无并发症发生。结论　腹腔镜 DST与低位 /超低位 /结 -肛吻合术治疗低位直肠癌 ,除具有创伤小、出血少、保肛率高、术后疼痛轻、恢复快等优点外 ,对自主神经丛的保护更准确 ,术后肛门括约肌功能及排尿功能良好 ,是一项微创治疗低位结肠癌的新技术

DST and Low/Ultralow/Colo-Anal Anastomoses Laparoscopically in the Treatment of Low Rectal Cancer

Objective To assess the feasibility and adequacy of double stapling technique(DST) and anal sphincter preservation with laparoscopic approach for low rectal cancer. Methods DST and low/ultralow/colo anal anastomoses were performed laparoscopically on 30 patients with low rectal cancer. Results The 30 laparoscopic DST and low/ultralow/colo anal anastomoses with anal sphincter preservation were successfully completed, and not one of the cases was converted to open procedures. The operation time was 155 min with the ranges from 110 to 320 min. The operative blood loss was 20ml with a range between 5 and 80 ml. The time of bowel function restoration and post operative ambulation was 1~2 days after the operation. 14 patients had postoperative analgesic requirement. The hospital stay varied from 5 to 14 days, averaging 8 days, and there were no intraoperative and postoperative complications in the 30 patients. Conclusion Laparoscopic DST and low/ultralow/colo anal anastomoses for low rectal cancer is a perspective minimally invasive technique, which is feasible, safe and effective. With the use of this technique, surgeons could accomplish higher rates of sphincter preservation, more accurate autonomic nerve preservation and good micturation with decreased postoperative pain and rapid recovery.