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目的探讨经自然腔道取出标本腹腔镜直肠癌根治术的可行性与疗效。方法回顾性分析16例经自然腔道取出标本腹腔镜直肠癌根治术患者的临床资料,对手术的可行性、安全性、根治性等进行评价。结果16例手术均获成功,无中转术式,无严重术中术后并发症,无手术相关死亡。手术平均时间为156(90~210)min,平均失血量147(50～350)ml,术后平均留置导尿时间10(7～15)d,平均住院日14(10~21)d。所有患者3个月后排便控便功能均良好。平均清扫淋巴结13(8~21)枚,11例低位直肠癌平均远切缘1.7(1~4)cm,无切缘阳性病例。结论经自然腔道取出标本腹腔镜直肠癌根治术安全可行,同时具有腹部创口最小化、降低直肠低位横断的难度等优点。
Objective To investigate the feasibility and efficacy of laparoscopic radical resection of colorectal cancer by removing natural specimens. Methods The clinical data of 16 patients who underwent laparoscopic radical resection of colorectal cancer after removal of the natural cavity were retrospectively analyzed. The feasibility, safety and curative effect of the operation were evaluated. Results All the 16 surgeries were successful. There was no operative procedure, no severe postoperative complications and no operative death. The average operation time was 156 (90 ~ 210) min and the average blood loss was 147 (50 ~ 350) ml. The average postoperative catheterization time was 10 (7 ~ 15) d and the average length of stay was 14 (10 ~ 21) d. All patients had good defecation control after 3 months. The average dissection lymph nodes 13 (8 ~ 21) pieces, 11 cases of low rectal cancer average distal margin of 1.7 (1 ~ 4) cm, no case of positive margins. Conclusions The laparoscopic radical resection of the rectum with natural laparoscopic resection is safe and feasible. It also has the advantages of minimizing the abdominal wound and reducing the difficulty of transection of the lower rectum.