摘要
目的分析腹腔镜直肠癌根治术中转开腹手术的原因,为腹腔镜直肠癌根治手术选择合适病例提供参考。方法回顾性分析了该科2003年2月～2007年2月采用腹腔镜行直肠癌根治手术的208例患者的资料,其中中转开腹手术32例,分析中转原因和术后并发症。结果因腹腔内出血中转6例,肿瘤较低位4例,肿瘤较大5例,腹内脏器损伤8例,腹腔粘连重6例,肥胖2例,吻合口渗漏1例。结论腹腔镜行直肠癌根治术具有一定的中转开腹手术率,但应尽量避免不必要的中转开腹手术,腹腔脏器损伤和腔内出血是中转开腹的主要原因,腹腔粘连、肥胖和肿瘤位置大小等并不是腹腔镜直肠癌根治手术的绝对禁忌证。
[Objective] To investigate the reasons of converting laparoscopic rectal cancer resection to open surgery and provide the reference for choosing proper patients who need laparoscopic surgery. [Methods] From February 2003 to February 2007, the data of 208 cases which received laparoscopic rectal cancer resection and 32 cases conversion of laparoscopic rectal cancer resection were analyzed retrospectively. The reasons of conversion and the postoperative complications were explored. [Results] There were 6 cases with bleeding in abdominal cavity, 4 cases with tumors lying super blow, 5 cases with tumors being more big, 8 cases with viscera injury, 2 cases with obesity, and 1 cases with leakage in anastomotic stoma switched the surgical option. [Conclusion] Rectal cancer radical resections with laparoscope have relatively conversion rates, but unnecessary conversion should be avoided. Viscera injury and bleeding in abdominal cavity are the main causes of conversion laparoscopic procedure. Adhesion in abdominal cavity, obesity, the size and position are not the contraindication of laparoscopic radical cancer resection.
出处
《中国内镜杂志》
CSCD
北大核心
2008年第3期240-242,共3页
China Journal of Endoscopy
