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目的 探索腹腔镜全直肠系膜切除 (TME)低位、超低位前切除治疗低位直肠癌的可行性。 方法 按TME原则、用双钉合技术 (DST) ,在腹腔镜下对 6 2例低位直肠癌患者实施TME、DST低位、超低位结肠 肛管吻合术。 结果 手术时间 110～ 2 10min ,平均 12 5min ;术中出血 5～ 80ml,平均 2 0ml;术后 1～ 2d恢复胃肠功能并下床活动 ,住院时间 5～ 14d ,平均 8d。 1例患者因凝血障碍中转开腹 ,其他 6 1例患者手术顺利。术后疼痛剂应用 2 8例 ,除 1例吻合口漏、1例尿潴留外 ,其余患者未见术中及术后并发症。 结论 腹腔镜TME、低位、超低位吻合术治疗低位直肠癌 ,创伤小、保肛率高、术后疼痛轻、恢复快 ,是极具应用前景的微创新技术。
Objective To explore the feasibility of laparoscopic total mesorectal excision (TME) low and ultra-low anterior resection of low rectal cancer. Methods According to the TME principle, 62 patients with low rectal cancer underwent laparoscopic TME, DST low and ultralow colorectal anastomosis with double stitching technique (DST). Results The operation time ranged from 110 to 210 minutes with an average of 125 min. Intraoperative bleeding ranged from 5 to 80 ml with an average of 20 ml. The gastrointestinal function was restored and ambulation was resumed 1 to 2 days after operation. The hospitalization time was 5 to 14 days with an average of 8 days. One patient was converted to open surgery due to coagulopathy, and the other 61 patients successfully operated. There were 28 cases of postoperative pain medication, except one case of anastomotic leakage and 1 case of urinary retention, while the other patients had no intraoperative and postoperative complications. Conclusion laparoscopic TME, low, low anastomosis for the treatment of low rectal cancer, trauma, anal sphincter rate, postoperative pain and recovery quickly, is a very innovative micro-innovative technology.