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目的探讨腹腔镜术中联合结肠镜治疗结直肠小占位病变的可行性和临床应用价值。方法对我院2006年12月至2009年5月期间23例行腹腔镜联合结肠镜手术的结直肠小占位病变患者的临床资料进行回顾性分析。结果所有患者均在腹腔镜下完成手术,无中转开腹。手术时间80~200 min,平均140 min;出血80~120 ml,平均100 ml。9例息肉病变行局灶切除,术中经快速冰冻切片病理证实4例早期癌及10例不典型增生均行相应肠段切除。术后1例出现轻度肺炎,经积极抗炎对症治疗后痊愈,其余患者恢复良好。所有患者术后第1天即离床活动,住院时间5~10 d,平均7 d。结论腹腔镜术中联合结肠镜治疗结直肠占位是安全可行的,有助于结直肠病灶及切缘的准确定位,可缩短手术时间,值得临床进一步推广应用。
Objective To investigate the feasibility and clinical value of combined colonoscopy in the treatment of small colorectal lesions in laparoscopic surgery. Methods The clinical data of 23 patients with small colorectal lesions undergoing laparoscopy combined with colonoscopy from December 2006 to May 2009 in our hospital were analyzed retrospectively. Results All patients underwent laparoscopic surgery without conversion to laparotomy. Surgery time 80 ~ 200 min, an average of 140 min; bleeding 80 ~ 120 ml, an average of 100 ml. Nine cases of polyposis lesions were treated with focal resection. Four sections of early stage carcinoma and 10 cases of atypical hyperplasia were confirmed by rapid frozen section pathology. Postoperative one case of mild pneumonia, after active anti-inflammatory symptomatic treatment recovered, the rest of the patients recovered well. All patients were out of bed after the first day of activity, hospital stay 5 ~ 10 d, an average of 7 d. Conclusion Combined colonoscopy in laparoscopic surgery for colorectal space occupying is safe and feasible, which is helpful for the accurate localization of colorectal lesions and margins. It can shorten the operation time and deserve further clinical application.