改良无辅助切口完全腹腔镜直肠癌全直肠系膜切除术的临床研究

目的研究改良无辅助切口完全腹腔镜直肠癌全直肠系膜切除术(TME)在直肠癌治疗中的临床效果。方法回顾性总结2007年5月~2010年6月在本院接受改良无辅助切口完全腹腔镜直肠癌TME术治疗的23例患者的临床资料。结果 23例均获成功,平均手术时间242.5 min,术中平均出血量52.6 mL。术后病理证实远近切缘均无癌残留。术后平均胃肠功能恢复时间51.7 h,术后平均住院时间5.4 d。无吻合口瘘及出血、腹腔出血及感染等术后并发症。随访12~18个月,未发现肿瘤局部复发。结论改良无辅助切口完全腹腔镜直肠癌TME术具有手术损伤小、出血少、无腹壁辅助切口、恢复快等优点,是真正意义上的全腹腔镜下直肠癌微创手术,值得临床推广应用。

Clinical research on improved total laparoscopic and total mesorectal excision without auxiliary incision for rectal carcinoma

Objective To study the clinical effect of improved total laparoscopic and total mesorectal excision(TME) without auxiliary incision for rectal carcinoma.Methods The clinical data of 23 patients with rectal carcinoma who received improved total laparoscopic and total mesorectal excision(TME) without auxiliary incision from May 2007 to June 2010 were analyzed retrospectively.Results All of the 23 patients had successful operations.The average operation duration was 242.5 min,and the average bleeding volume was 52.6 mL.The postoperative pathology confirmed that the cut edge had no residual cancer.The average recovery time of gastrointestinal function was 51.7 h,and the average length of stay was 5.4 d.There was no postoperative anastomotic fistula and bleeding,abdominal bleeding and infection.The follow-up ranging from 12 to 18 months revealed that there was no local recurrence.Conclusion Improved total laparoscopic and TME without auxiliary incision for rectal carcinoma has the advantages of smaller injury,less blood loss,no abdominal wall auxiliary incision,and faster recovery,is a real total laparoscopic minimally invasive surgery for rectal carcinoma,thus being worthy of clinically wider application.