腹腔镜辅助下结直肠癌手术的疗效分析
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牛彦锋

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Evaluation of outcome of laparoscopic-assisted surgery for colorectal carcinoma
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    目的:探讨腹腔镜辅助下结直肠癌手术的可行性、安全性、并发症及近期临床疗效。方法:回顾性分析4年间112例腹腔镜下结直肠癌手术患者的临床资料,包括右半结肠切除23例,左半结肠切除7例,乙状结肠癌切除15例,Dixon术49例,Miles术18例。结果:105例手术成功,7例因出血、肥胖及与邻近器官粘连而中转开腹手术,其中左半结肠2例,直肠癌4例。平均手术时间(161.2±48.6) min,平均出血量78.5mL。术后早期并发症8例,无围手术期死亡。结肠癌标本近、远切缘长度分别为(14.5±3.2)cm和(11.0±2.6)cm,直肠癌标本近、远切缘长度分别为(15.3±2.7)cm和(2.8±1.6)cm。清扫淋巴结平均(8.2±4.6)枚,49例淋巴结转移。随访8~44个月,随访率95.5%。随访未发现戳孔肿瘤种植,局部复发7例(6.5%),远处转移6例(5.6%),总病死率7.5%(8/107)。结论:腹腔镜下结直肠癌手术不仅安全可行,具有微创优势,并可达到与开腹同样的肿瘤根治性效果。

    Abstract:

    Abstract:Objective:To evaluate the feasibility, safety and short-term outcome of laparoscopic-assisted surgery for colorectal cancer. Methods:From August 2001 to November 2004, laparoscopic resection of colorectal carcinoma were performed in 112 cases, including right hemicolectomy(n=23), left himicolectomy(n=7), radical resection of sigmoid cancer(n=15), Dixon procedure(n=49), and Miles procedure(n=18). Results:One hundred and five patients underwent laparoscopic resection successfully, 7 cases were converted to open surgery because of hemorrhage, obesity or adhesion with adjacent organ, 6 of which were left colon or rectal cancer. The mean operating time was (161.2±48.6)min, and the mean operative blood loss was 78.5 mL. There were 8 cases occurred postoperative complications, and no mortality during perioperative period. The length of upper and lower segment of resection for colonic cancer was (14.5±3.2)cm and (11.0±2.6)cm respectively. The length of upper and lower segment of resection for rectal cancer was (15.3±2.7)cm and (2.8±1.6)cm, respectively. The mean number of lymph nodes dissected was (8.2±4.6), and lymph node metastases were found in 49 cases. One hundred and seven cases(95.5%) were followed up for 8-44 months, of which, 7 cases had local recurrence and 6 cases had distant metastases. No case of trocar port tumor implantation was observed. Conclusions:Laparoscopic surgery for colorectal cancer is feasible and safe, can result in the same outcome as open radical surgery, and has the advantages of mini-invasive procedure.

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王国斌,牛彦锋,卢晓明,陶凯雄,蔡开琳,龙跃平,舒晓刚,帅晓明.腹腔镜辅助下结直肠癌手术的疗效分析[J].中国普通外科杂志,2006,15(8):1-564.
DOI:10.7659/j. issn.1005-6947.2006.08.001

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  • 在线发布日期: 2006-08-25