腹腔镜直肠癌根治术的临床体会(附42例报告)

目的:探讨腹腔镜直肠癌根治术的临床疗效及应用价值。方法:回顾分析2009年4月至2011年4月为42例直肠癌患者行腹腔镜根治术的临床资料。结果:41例(97.6%)成功完成腹腔镜手术,1例中转开腹。手术时间平均95 min,术中出血量平均30 ml,术后胃肠道功能恢复时间平均36 h,平均住院9 d,无围手术期死亡及并发症发生,术后38例按Folfox及Eelox方案化疗。随访3～24个月,平均18个月,切口均无肿瘤种植转移及复发。中转开腹患者于术后3个月死于肿瘤广泛转移导致的全身多器官功能衰竭。结论:腹腔镜直肠癌根治术具有患者创伤小、术后康复快、术中出血少、解剖清晰、切除病灶彻底等优点,值得推广应用。

Clinical application of laparoscopic radical resection for colorectal cancer: with a report of 42 cases

Objective:To discuss the efficacy and application value of laparoscopic radical surgery for rectal cancer.Methods:The clinical data of 42 patients with rectal carcinoma who underwent laparoscopic rectal resection from Apr.2009 to Apr.2011 were analyzed retrospectively.Results:One case was converted into laparotomy and laparoscopic techniques.41 cases(97.6%) were successfully treated with laparoscopic radical surgery.The average operation time was 95 min,and blood loss was 30ml.Gastrointestinal function recovery time was 36h,and the average hospitalization time was 9 days.Eelox and Folfox chemotherapy were executed in 38 patients after surgery.A patient who converted to laparotomy died of widespread metastatic tumor caused by multiple organfailure on the 3 months after operation.No deaths or other complications occurred in the others during follow-up period.No tumour implantation metastasis and laparoscopic trocar-related tumor implantation were detected during the follow-up period.Conclusions:The results clearly demonstrate that laparoscopic radical surgery for colorectal cancer is as safe,feasible and effective as open surgery.