内镜指导下腹腔镜手术治疗胃肠道肿瘤
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黄忠诚 E-mailHuangzc369@163.com

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Resection of gastrointestinal tumors by endoscopy combined with laparoscopy
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    摘要:

    目的:探讨内镜联合腹腔镜手术治疗胃肠道肿瘤的适应范围、安全性和可行性。
    方法:对我院2007年9月—2010年7月进行的30例内镜指导下腹腔镜手术治疗胃肠道肿瘤的临床资料进行回顾性分析,其中胃间质瘤2例,结肠腺瘤20例,早期结肠腺瘤局灶性癌变8例。
    结果:30例手术均顺利完成,手术定位准确,无中转开腹者。手术时间40~90 min,术中出血量10~40 mL,胃肠功能恢复时间1~2 d。术后未发生大出血、吻合口漏、切口感染或腹腔内感染、尿潴留等并发症。住院时间4~6 d。术后随访6~24个月均未见复发。
    结论:内镜指导下腹腔镜手术对于内镜下难以切除,而腹腔镜下又定位困难的胃肠道肿瘤,具有定位准确、创伤小、并发症少、术后恢复快等特点,为胃肠道小肿瘤的微创治疗提供了一种新的思路和合理的治疗方案,值得临床推广应用。

    Abstract:

    Objective:To evaluate the indications,safety and feasibility of endoscopy combined with laparoscopy in the treatment of gastrointestinal (GI) tumors.
    Methods:The clinical data of 30 patients who underwent endoscopy-directed laparoscopic resection of GI tumors from September 2007 to July 2010 were retrospectively studied. Among these tumors,2 were gastric stromal tumor,20 were colorectal adenoma,and 8 were proved to be polyp with cancerous change.
    Results:Thirty patients were treated successfully and no patient was converted to laparotomy.The mean time of operation was 40~90 min,blood loss ranged from 20 mL to 50 mL, and the time of rcturn of bowel function was 1~2 days.No complication such as hemorrhage, anastomotic stomal leak, infection of incisional wound or infection of abdominal cavity occurred. postoperative hospital stay was 4 to 6 days.Follow-up of the 30 cases for 6-24 months after operation showed that no recurrence occurred.
    Conclusions:Gastroenteric tumor resection by endoscopy combined with laparoscopy demonstrates its advantages such as precise tumor localization, safety,mini-trauma, few complications and quick recovery, and its widespread use is recommended.

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黄忠诚| 刘祺| 刘升锋| 苏冀| 罗维珍.内镜指导下腹腔镜手术治疗胃肠道肿瘤[J].中国普通外科杂志,2010,19(10):1123-1125.
DOI:10.7659/j. issn.1005-6947.2010.10.016

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  • 收稿日期:2010-05-18
  • 最后修改日期:2010-09-14
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  • 在线发布日期: 2010-10-15