腹腔镜下全结肠切除治疗多原发结肠癌3例

目的:探讨腹腔镜下全结肠切除术的可行性和安全性。方法:回顾分析腹腔镜全结肠切除术3例的临床资料。3例均为多原发结肠癌,在腹腔镜辅助下行全结肠切除术,并行肿瘤区域淋巴结清扫、回肠直肠吻合术。结果:3例手术顺利完成,无中转开腹,无手术死亡。平均手术时间300min(270～330min),平均出血量110ml(80～150ml),辅助切口平均长度6cm(5～7cm),平均术后住院8d(7～10d),无手术并发症。术后随访3例患者6～18个月,其中1例术后2个月出现肝内多发转移癌和脾转移癌,行B超介入射频治疗和静脉联合化疗后至今存活。结论:腹腔镜辅助全结肠切除术治疗多原发结肠癌安全可行,近期疗效良好。

Laparoscopy-assisted total colectomy for multiple colonic cancer:a report of 3cases

Objective: To investigate the feasibility of laparoscopy-assisted total colectomy for advanced multiple colonic cancer.Methods: Three cases of laparoscopy-assisted total colectomy performed from June 2003 to June 2004 were retrospectively analyzed.All patients with multiple colonic cancer were treated with total colectomy,regional lymph nodes dissection and ileorectostomy anastomosis by laparoscopic instruments.Results: All were successful,none was transferred to open surgery,no complications and mortality were found,the mean operative time was 300 minutes(270-330minutes),the mean blood loss was 110ml(80-150ml),the mean length of assisted incision was 6cm(5-7cm),the mean postoperative hospitlization was 8 days(710days).Followed up from 6 to 18 months,1 patient was found multiple metastases in liver and spleen after 2 months,and treated by radiofrequency catheter ablation(RFCA) and chemotherapy.Conclusions: Laparocopy-assisted total colectomy for advanced multiple colonic cancer is feasible and safe,with a favorable short-term outcome.