腹腔镜结直肠癌手术临床疗效探讨

目的评价腹腔镜结直肠癌手术的疗效。方法回顾性分析84例腹腔镜结直肠癌手术的临床和病理资料。结果84例患者无手术死亡，81例完成腹腔镜手术，中转开腹3例（3．6％）。左、右半结肠切除术各5例，乙状结肠切除术29例，直肠前切除术35例，腹会阴联合切除术10例。手术时间平均246min（150—360min），出血量平均198ml（20～1000ml），术后排气时间平均2．9d（1～6d）。淋巴结切除数平均15个（5—28个），直肠前切除术肿瘤下切缘长度平均4．5em（2—7cm），切缘均阴性。吻合口漏2例（2．4％），右侧输尿管损伤1例（1．2％）。无穿刺孔和切口肿瘤种植。术后平均随访29个月（6～51个月），肿瘤相关死亡10例（11．9％）。结论腹腔镜结直肠癌手术是安全可行的，可以达到根治切除肿瘤的效果。

Clinical therapeutic effect of laparoscopic colorectal cancer surgery

Objective To evaluate the therapeutic effect of laparoscopic colorectal cancer surgery.Methods Clinical data of 84 patients treated with laparoscopic colorectal surgery for colorectal cancer from September 2004 to September 2007 was retrospectively analyzed.Results Among 84 cases,5 cases underwent right hemicolectomy,5 cases had left hemicolectomy.29 cases had sigmoidectomy,35 cases had anterior resection and 10 cases had abdominoperineal resection.Conversion to open surgery was done in 3(3.6%)patients undergoing the laparoscopic procedure.The average duration of operation was 246(150～360)min and blood loss was 198(20～1000)ml.The median time of first howel movement was 2.9(1～6)days.Lymph-node yield was 15.1(5～28).Anastomotic leakage occurred in two patients and ureteric injury occured in one patient.There was no pert site recurrence.The median follow-up time was 29(6～51)months.10 patients(11.9%)died of tumor-related diseases.Conclusion Laparoscopic procedure is aclinically feasible and safe therapy for colorectal cancer.