经脐单孔+1孔腹腔镜结直肠癌根治术的可行性研究

目的:探讨经脐单孔+1孔腹腔镜(single-incision plus one-port laparoscopic surgery,SILS+1)结直肠癌根治术的安全性及可行性。方法:回顾性分析2017年10月至2019年11月赣南医学院第一附属医院收治的8例进行经脐SILS+1结直肠癌根治术患者的临床资料。结果:8例结直肠癌患者手术均顺利完成,无中转开腹及增加戳卡孔数量,手术平均时间107(95~124)min,平均出血33(10~80)mL,2例患者出现术后发热,考虑术后吸收热可能,术后第3天自行退热,其余患者术后无明显外科并发症,术后1~3天胃肠道功能恢复,3~5天拔出腹腔引流管,术后住院时间约9.3(7~11)天。术后病理再次证实为结直肠腺癌,淋巴结检出平均数目为13.6(11~16)枚,均无围手术期严重并发症及死亡的发生。术后随访3~24个月,平均10个月,未发现肿瘤局部复发、腹壁戳孔切口种植转移。结论:经脐SILS+1结直肠癌根治术安全可行,创伤小,美容效果令人满意,但远期疗效有待进一步观察。

Transumbilical single-incision plus one-port laparoscopic surgery for colorectal cancer: a feasibility study

  Objective  To explore the safety and feasibility of single-incision plus one-port laparoscopic surgery (SILS+1) for colorectal cancer.  Methods  The clinical data of 8 patients with colorectal cancer who were admitted to hospital for transumbilical SILS+1 between October 2017 and November 2019 were retrospectively analyzed.  Results  The procedure was successfully performed in all 8 cases, without needing to convert to open surgery or increase the number of punch holes. The mean operating time was 107 minutes (range:95 to 124 minutes). Blood loss ranged from 10 to 80 mL (median:33 mL). Two patients had a fever postoperatively. Postoperative heat absorption was considered, and the fever reduced after the third day. The other patients had no obvious surgical complications. Gastrointestinal function was restored 1 to 3 days after the operation, and the abdominal drainage tube was removed after 3 to 5 days. The average hospital stay was 9.3 days (range:7 to 11 days). Postoperative pathology confirmed colorectal adenocarcinoma in all patients. The average number of lymph nodes detected was 13.6 (range:11-16). No perioperative complications or deaths occurred. Patients were followed up for 3-24 months (average:10 months), and no local recurrence or distant metastases were found.  Conclusion  Although SILS+1 for colorectal cancer appears to be safe and feasible, with minimal trauma and satisfactory cosmetic effect, the long-term effects require further observation.