低位直肠癌腹腔镜辅助下经肛门拖出双吻合器切除术(附12例报告)

目的:探讨腹腔镜下经肛门拖出双吻合器切除在低位直肠癌手术中的应用。方法:回顾分析为12例低位直肠癌患者施行腹腔镜辅助下经肛门拖出双吻合器切除术的临床资料。结果:12例手术均获成功,无中转开腹,手术时间180～260min,平均210min,出血量50～500ml,平均160ml。术后切缘病理检查均未见癌细胞浸润,无吻合口漏及手术死亡病例。12例患者均获随访,随访时间3～14个月,随访期内肝转移1例,无吻合口复发,1例术后8个月仍每天排便3～5次,余者2～4个月后排便正常。结论:低位直肠癌腹腔镜辅助下经肛门拖出双吻合器切除术安全可行,熟练的开腹手术经验及腹腔镜操作技巧是手术成功的关键。

Laparoscopic-assisted low rectal carcinoma trans-anal pulled-out resection with double-stapler:with a report of 12 cases

Objective:To discuss the application of laparoscopic-assisted low rectal carcinoma trans-anal pulled-out resection with double-stapler.Methods:The retrospective analysis was performed on the clinical data of 12 patients who suffered from low rectal carcinoma and underwent laparoscopic-assisted low rectal carcinoma trans-anal pulled-out resection with double-stapler.Results:Twelve operations were successfully performed.The operative time was 180-260min (average,210min),and the blood loss was 50-500ml(average,160ml).No malignant cell infiltration at incision margin was found.No anastomotic leakage or death occurred.All patients were followed up for 3-14 months.Liver metastasis occurred in 1 patient,and no anastomotic recurrence was found.During the 8 months after operation,1 patient defecated 3-5 times per day,and the defecation of other patients became normal 2-4 months later.Conclusions:Laparoscopic-assisted low rectal carcinoma trans-anal pulled-out resection with double-stapler is safe and feasible,and the keys of operation success are skilled laparotomy experience and laparoscopic techniques.