69例直肠癌腹腔镜下TME手术的临床分析

目的：探讨直肠癌腹腔镜下TME手术的可行性及处理经验。方法：回顾分析2004年9月～2009年12月我院实施的69例直肠癌腹腔镜根治手术（TME）的临床资料。结果：48例行前切除（Dixon）术，21例行Miles术，全部在腹腔镜下完成。本组病例切除肠段的近端距肿瘤至少15cm，远断端至少2cm以上，平均手术时间168（110～240）分钟，平均术中出血90（60－350）毫升，肛门术后排气时间（1-3）天，平均淋巴结清除的个数15（9—19）个。平均住院时间10（8～18）天。术后一例前切除患者出现吻合口瘘。61例获随访，随访6-48个月。2例Miles术后2年会阴处复发，予转放射治疗。所有患者未见Trocar孔、切口的种植及吻合口复发，未出现术后排尿困难病例。结论：腹腔镜直肠痛车来可以达到和开放丰术一样的肿瘤根治标准．是安全有效的外科治疗手段。

Clinical analysis of 69 cases with laparoscopic radical resection (TME) of rectal carcinoma

Objective：To investigate the feasibility and experience of laparoscopie radical resection （TME） for rectal carcinoma Methods：The clinical data of 46 eases who under went laparoscopic radical resection of rectal carcinoma in our department from SEP 2004 to DEC2009 were analyzed retrospectively Result： Dixon surgery were performed on 48 cases ,and Miles surgery were carried out on 21 patients, the whole patients were treated by laparoscopy successfully.The average operation time was 168（110-240） rain, mean blood loss was 90 （60-350）ml,gastroi-ntestinal function recovery time was （1-3） days,and the average hospitalization time was 10（8-18） days. The average number of 15（9-19） lymph nodes removed.Postoperative complications about anastomotic leakage was only 1 cases of Dixon.During the follow up period of 6-48 months in 61 cases,Two cases of Miles Perineal recurrence after 2 years,then turned radiotherapy.No Punch hole Incision metastasis and Recurrence in anastomotie stoma occurred during foUow-up.No eases of obstructive voiding symptoms in postoperative. Result：Laparoseopie colorectal surgery and open surgery can achieve the same standard of cancer cure ,which is safe and effective surgical treatment.