腹腔镜结合经肛拖出式双吻合在低位直肠癌中的运用

目的探讨腹腔镜结合经肛拖出式双吻合在低位直肠癌中运用的可行性。方法回顾分析腹腔镜结合经肛拖出式双吻合25例直肠癌根治术的临床资料。结果本组23例保肛成功;手术时间平均185min;术中出血量平均190mL;术后肛门排气时间平均3.4d;完全达到正常排便平均时间18d;术后进食时间平均3.5d,手术切除淋巴结平均9枚。2例并发吻合口瘘,经禁食、冲洗引流1周治愈。会阴切口感染1例,经抗感染、换药13d治愈,随访6~21个月,无复发和死亡病例。结论腹腔镜结合经肛拖出式双吻合在直肠癌根治术中具有安全、微创、根治性良好等优势,同时能提高保肛率。

The Application of Laparoscopy and Anal Drag Double Anastomosis in Low Rectal Cancer

Objective To explore the transanal pull-through laparoscopic combined with double low rectal anastomosis in the feasibility of applying.Methods Retrospective analysis of laparoscopic transanal pull-through combined with double anastomosis in 25 cases of radical resection of rectal cancer clinical data.Results In 23 cases of anus-preserving operation success;a mean time of 185 min;intraoperative bleeding volume average of 190mL;postoperative anal exhaust time average of 3.4 days;fully meet the normal defecation time average（18 days）;eating in patients after a mean time of 3.5 days,an average of 9 lymph node resection operation.2 cases of anastomotic fistula after fasting,drainage,1 weeks to heal.Perineal incision infection in 1 cases,anti-inflammatory,dressing change after 13 days to cure,followed up for 6 ~ 21 months,no recurrence and death cases.Conclusion Laparoscopic transanal pull-through combined with double anastomosis in radical resection of rectal carcinoma with safe,minimally invasive,radical advantages such as good,and can improve the sphincter preserving rate.