手辅助腹腔镜在结直肠肿瘤手术中的应用

目的探讨手辅助腹腔镜技术（HALS）在结直肠肿瘤手术中的安全性和有效性。方法回顾性分析接受HALS治疗的70例结直肠癌患者的临床资料。结果70例患者中男性38例．女性32例．中位年龄61岁。乙状结肠腺瘤4例,乙状结肠癌48例,降结肠癌3例,升结肠癌1例．直肠癌13例,全结肠切除1例。所有患者均顺利完成HALS,无中转开腹病例。手术时间为（126．0±22．5）min：术中出血（75．0±18．8）ml;平均清扫淋巴结（16．8±4．2）枚,术后平均住院9．4d。无围手术期死亡病例,术后1例患者出现吻合口狭窄,2例吻合口瘘,均经保守治疗好转。结论HALS用于结肠癌手术创伤小、易掌握、安全性高,具有良好应用前景。

Application of hand-assisted laparoscopic surgery (HALS) in colectomy

Objective To evaluate the safety and efficacy of hand-assisted laparoscopic surgery (HALS) in colorectal tumors. Methods Clinical data of 70 patients with colorectal tumors were retrospectively analyzed. All the patients had received HALS colectomy in the Beijing Cancer Hospital. Lapdisc was used for the hand port at the umbilicus. Two additional trocars were used. Results There were 38 males and 32 females. The median age was 61(29-89) years. Diagnoses included sigmoid cancer(n=48), sigmoid adenoma(n=4), descending colon cancer(n=3), ascending colon cancer(n=1),rectal cancer (n=13), total colectomy (n=1). The operative time was (126.0 ±22.5) minutes. The intraoperative blood loss was (75.0±18.8) ml. The mean number of lymph node dissection was (16.8±4.2). The median postoperative hospital stay was 9.4 days. There were no perioperative deaths. One patient developed anastomotic stricture and two anastomotic leak, all of which were successfully managed with conservative treatment. Conclusion HALS is a safe and effective technique for colectomy.