手辅助腹腔镜结直肠癌手术的临床体会

目的探讨手辅助腹腔镜(hand-assisted laparoscopic surgery,HALS)在结直肠癌手术中的临床应用。方法结合自2010～2011年2年间所开展的17例蓝碟装置手辅助腹腔镜结直肠癌手术,并查阅了相关的文献资料,总结分析手辅助腹腔镜技术在结直肠癌手术中的临床经验体会。结果 17例手术患者中,仅1例上段直肠癌因肿块浸润粘连严重予中转开放手术,其余16例患者均能顺利完成微创手术,未发生邻近脏器组织损伤。采用手辅助腹腔镜结直肠癌切除手术方式,手术时间较传统开腹手术时间延长并不明显,但手术创伤出血、术后疼痛及功能恢复等均较开放手术有明显优势。患者术后恢复快,并发症少。结论 HALS具有现代全腹腔镜手术和传统开腹手术的共同优点,是结直肠全腹腔镜手术的有力补充,有良好的应用前景。

Clinical Experience of Lap Disc Hand-Assisted Laparoscopic Surgery(HALS) in Colorectal Cancer Operation

Objective To evaluate the application of Hand-assisted laparoscopic surgery in colorectal cancer operation.Methods The data of 17 cases of hand-assisted laparoscopic surgery through lap disc device in colorectal cancer operation from 2010 to 2011 was analyzed,the related literature and data were consulted,and a summary on the clinical experience of Hand-assisted laparoscopic surgery in colorectal cancer operation was made.Results Only 1 case with upper rectal cancer out of the 17 cases was converted to open colorectal surgery because of its close invasion adherence,and the other 16 cases were completed smoothly without any injury to adjacent organs and tissues.Compared with conventional open colorectal surgery,HALS did not prolong significantly time of operation,but had obvious advantage for operative hemorrhage and recovery of postoperative pain and function.After the HALS,the patients showed good postoperative effects and less complication.Conclusion HALS conjugated the advantages of modern total laparoscopic surgery and conventional open colorectal surgery,strongly complements the total laparoscopic surgery,and showed good prospect of application.