腹腔镜直肠癌手术方法探讨

目的:探讨腹腔镜手术治疗直肠癌的方法与可行性。方法:2002年3月至2008年3月,我院为42例直肠癌患者施行腹腔镜直肠癌根治切除术,术中应用彭氏多功能手术解剖器(Peng's multifunctional operational dissection,PMOD)行全直肠系膜切除术,31例行直肠外翻切除术,6例腹腔内直肠切除远侧端拉出肛门外用国产吻合器行结直肠吻合术,5例高位直肠癌患者中1例腹腔内荷包缝合,4例用闭合器钉合远侧端再用吻合器完成结直肠吻合术。结果:42例手术均获成功。手术时间120~260min,平均160min;术后1~3d恢复胃肠功能并下床活动,术后住院6~12d,平均9d。术中及术后均无并发症发生。结论:腹腔镜直肠癌手术中应用PMOD行全直肠系膜切除术,中下段直肠癌行直肠外翻切除术,用国产吻合器吻合结直肠手术安全可靠,可以替代进口吻合器的双吻合技术。

The clinical research of laparoscopic radical resection of rectal carcinoma

Objective:To evaluate the methods and feasibility of laparoscopic radical resection of rectal carcinoma.Methods:From March 2002 to March 2008,42 patients with rectal cancer underwent laparoscopic radical resection which was based on the principle of total mesorectal excision.During the operation,Peng's multifunctional operational dissection(PMOD) was used.Thirty-one cases were performed with the technique of rectal stump eversion and external colorectal anastomosis.Four of five cases of high site cancer was carried out with double stapling technique,and 1 case was sutuered before stapling.Results:All cases were performed sucessfully.The mean operation time was 160(range 120-260)min.The recovery time of bowel function and average hospitalization was 1-3 days and 9(range 6-12) days respectively.No complication was observed during operation and postoperatively.Conclusions:The technique is feasible with minimal invasion and safe anastomosis.The cost is reduced by using the domestic produced staple which can take the place of the imported.