摘要
目的:探讨腹腔镜手术在结肠直肠肿瘤切除术中的应用和临床效果。方法:利用腹腔镜技术对109例结肠直肠肿瘤病人进行手术,并对手术操作、术后情况以及并发症等进行分析。结果:109例病人中转开腹手术11例,占10.1%。98例采用腹腔镜方法完成手术切除,其中结肠直肠腺瘤3例,结肠直肠癌95例。95例结肠直肠癌行姑息性切除5例,根治性切除90例;术式为Miles手术31例,右半结肠切除27例,乙状结肠切除18例,前切除16例,降结肠切除2例,横结肠切除1例。本组病人术中无其他脏器损伤、大出血、气体栓塞等发生,术后无因出现并发症而行再手术治疗者,无一例死亡。在进行根治性切除并达到术后半年以上的病人中,目前有局部复发1例,肝和肺转移各1例,术后复发转移率为5.7%。目前尚未发现有腹壁切口和穿刺孔转移。结论:腹腔镜结肠直肠肿瘤切除手术创伤小,安全、可行,具有广阔的推广应用前景。
Objective To evaluate the role of laparoscopic technique in the colorectal tumor resection. Methods Laparoscopic colorectal surgery was performed in the treatment of 109 patients with colorectal tumors. The operative procedures, postoperative conditions and complications were analyzed. Results Of these 109 patients, 11 cases （10.1%） were converted to open laparotomy. Laparoscopic colorectal resections were successfully performed in 98 patients （3 cases of colorectal adenoma, 95 cases of colorectal cancer, and of them, 90 patients underwent the radical resection）. The operative procedures included Miles＇ operation, right hemicolectomy, sigmoid colon resection, and anterior resection. No death occurred in any of the patients during or after laparoscopic surgery, and no serious complications occurred which required additional operations. In a follow-up period of longer than 6 months, the local recurrence and metastasis rate was 5.8% in the patients with radical resection. There was no evidence of local metastasis in the port sites and abdominal incisions. Conclusions Laparoscopic colorectal resection is minimally invasive, technically safe and feasible. It could be considered to replace further most of the traditional open colorectal operations.
出处
《外科理论与实践》
2006年第5期397-399,共3页
Journal of Surgery Concepts & Practice
