基层医院开展腹腔镜辅助直肠癌根治术的体会

目的:探讨基层医院开展腹腔镜辅助直肠癌根治术的安全性与可行性。方法:回顾分析2010年1月至2012年12月采用腹腔镜辅助直肠癌根治术治疗32例直肠癌患者的临床资料。其中男19例,女13例;平均(56±22)岁,中位年龄56.8岁;Dukes分期A期2例、B期13例、C期17例。结果:30例顺利完成腹腔镜辅助手术,其中Miles术6例,Dixon术24例,中转开腹2例。手术时间平均(180±50)min;术中出血量平均(200±100)ml;术后肠蠕动恢复时间平均(48±12)h;术后无出血、切口感染等并发症发生,6例患者出现轻度尿潴留,4例发生吻合口漏,无死亡病例;术后平均住院(8±2)d。结论:熟悉解剖结构,腹腔镜操作技术熟练,基层医院开展腹腔镜辅助直肠癌根治术操作安全、患者创伤小、术后康复快。

The experience of laparoscopic-assisted radical surgery for rectal cancer in primary hospital

Objective：To investigate the safety and feasibility of laparoscopic-assisted radical surgery for rectal cancer in pri-mary hospital. Methods ： The clinical data and operative methods of 32 patients with rectal cancer who received laparoscopic-assisted radical surgery from Jan. 2010 to Dec. 2012 were retrospectively analyzed. There were 19 males and 13 females with a median age of 56.8 years old,the mean was （56 ± 22） years old. There were 2,13,17 cases in Dukes stage A, B and C. Results ： Thirty cases were successfully performed laparoscopic-assisted resection （6 for Miles and 24 for Dixon） ,2 cases were converted to open surgery and the rate of laparoscopic-assisted resection was 93.75 %. The mean operation time was about （ 180 ± 50） rain and the mean blood loss was a- bout （200 ± 100 ） ml. The average post-operative convalescence time of intestinal peristalsis was （48 ± 12 ） h. There were not operative complications such as hemorrhage or wound infection. There were 6 cases mild retention of urine and 4 cases anastomotic fistula. No pa- tients died. The average hospital stay after surgery was （8 ± 2） d. All patients were followed up for 1-12 months. Conclusions：On the basis of familiar anatomical structure and skilled laparoscopic technique, laparoscopic-assisted radical resection of rectal cancer is a safe, effective and minimally invasive approach in primary hospital, providing patients with a quick recovery.