腹腔镜在直肠癌根治术中的应用体会

目的:探讨腹腔镜直肠癌根治术的临床应用价值。方法:回顾分析2011年1月至2013年4月为112例患者行直肠癌根治术的临床资料,其中52例行腹腔镜辅助直肠癌根治术(腹腔镜组),60例行开腹手术(开腹组)。对比分析两组患者手术情况。结果:腹腔镜组1例中转开腹,51例成功完成手术;手术时间平均(150±21)min,术中出血量平均(122±45)ml,术后腹腔引流量平均(90±30)ml,术后肛门排气时间平均(2.9±0.8)d。术中无邻近脏器及输尿管损伤,术后发生切口感染脂肪液化2例,无出血、吻合口漏、排尿障碍及大便失禁等严重并发症发生及死亡病例。患者均于术后72 h内下床活动并恢复肠道功能,平均住院(9±3)d。结论:腹腔镜辅助直肠癌根治术具有患者创伤小、痛苦小、术中出血少、康复快、住院时间短、并发症少等优点,是治疗直肠癌微创、安全、有效的术式,可逐渐成为直肠癌的首选术式之一。

Application experience of laparoscopic radical resection of rectal cancer

Objective：To evaluate the clinical value of laparoscopic radical resection of rectal cancer. Methods：The clinical data of 52 patients with rectal cancer who underwent laparoscopic-assisted radical resection （laparoscopic group） and 60 patients with routine laparotomy （ open group） from Jan. 2011 to Apr. 2013 were retrospectively analyzed. Comparative analysis of two surgical groups was done. Results：In laparoscopic group ,51 cases were successfully performed laparoscopic-assisted radical operation ,and 1 case was transferred to open operation. The average operation time was （ 150 ± 21 ） rain, the mean intraoperative blood loss was （ 122 ± 45 ） ml, the mean postoperative abdominal drainage was （90 ± 30） ml, the average anus exhaust time after operation was （2.9 ± 0.8 ） d. None of the adjacent organ or ureter was injured in operation, and there was no. postoperative bleeding, anastomotic leakage, urination dysfunc- tion or fecal incontinence, except 2 cases of incision infection and fat liquefaction. Ambulation and intestinal function all recovered with- in 72 h, and the average hospital stay was （9 ±3 ） d. Conclusions ： Laparoscopic-assisted radical resection of rectal cancer has the ad- vantages of less trauma, less pain, less intraoperative bleeding, faster recovery, shorter hospital stay, and fewer complications. As a mini- mally invasive technique, laparoscopic radical resection is safe and effective, which could gradually become one of the preferred opera- tions for rectal cancer.