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目的探讨合并慢性阻塞性肺疾病(COPD)的患者行腹腔镜结直肠癌根治术的可行性。方法 2008年10月-2012年12月74例合并COPD患者接受腹腔镜结直肠癌根治术,回顾性分析患者临床资料,统计呼吸系统相关并发症发生率,评价手术安全性。结果术后发生肺部感染5例,切口感染2例,吻合口瘘2例,肺不张2例,无气胸、急性呼吸窘迫综合征尿路感染、深静脉血栓及肠梗阻发生无围手术期死亡;术后拔管时间(26.72±15.07)min,下床活动时间(2.18±0.91)d,排气时间(1.85±0.79)d,排便时间(4.14±1.06)d,进流质时间(2.62±0.70)d术后住院时间(10.53±1.75)d。术后随访3个月,无死亡或复发。结论在呼吸专科医师参与下通过充分细致的围术期处理,合并COPD的患者行腹腔镜结直肠癌根治术是可行的。
Objective To investigate the feasibility of laparoscopic radical resection of colorectal cancer in patients with chronic obstructive pulmonary disease (COPD). Methods From October 2008 to December 2012, 74 patients with COPD received laparoscopic radical resection of colorectal cancer. The clinical data of patients were retrospectively analyzed. The incidence of respiratory complications and the safety of surgery were evaluated. Results There were 5 cases of pulmonary infection, 2 cases of incision infection, 2 cases of anastomotic fistula, 2 cases of atelectasis, no pneumothorax, acute respiratory distress syndrome urinary tract infection, deep venous thrombosis and intestinal obstruction without perioperative period (26.72 ± 15.07) min, ambulation time (2.18 ± 0.91) d, exhaust time (1.85 ± 0.79) d, defecation time (4.14 ± 1.06) d, 0.70) d postoperative hospital stay (10.53 ± 1.75) d. All cases were followed up for 3 months without any death or recurrence. Conclusions Laparoscopic radical resection of colorectal cancer is feasible in patients with COPD through thorough and meticulous perioperative management with the help of respiratory specialists.