【摘 要】
:
Objective Recently laparoendoscopic single-site surgery is widely performed through transumbilical incision in appendectomy and cholecystectmy, but the practice in the more complex colorectal resectio
【机 构】
:
Department of General Surgery, Nanfang Hospital Southern Medical University, Guangzhou 510515, China
【出 处】
:
第十六届中国中西医结合学会大肠肛门病专业委员会学术会议
论文部分内容阅读
Objective Recently laparoendoscopic single-site surgery is widely performed through transumbilical incision in appendectomy and cholecystectmy, but the practice in the more complex colorectal resection is challenging.Here, Nanfang Hospital Southern Medical University report five patients with diagnosis of rectosigmoid cancer subjective to laparoendoscopic single-site (LESS) colorectomy through a pfannestiel incision with a glove access.Methods LESS colorectomy was performed through a Pfannestiel incision on each patient with diagnosis of rectosigmoid cancer.A 3-5 cm transverse Pfannestiel incision was made on the skin with pubic hair 3-4 cm above the pubic symphysis followed by a self-made glove access was constructed by inserting a soft tissue retractor and a surgical glove.High ligation of inferior mesenteric vessel and intracorporeal anastomosis were done.5 cases were included in this study.Each operation was completed with common laparoscopic instruments.Results The 5 procedures were completed successfully without intraoperative complications and conversions at 205, 68, 217, 115, and 108 minutes.The estimated blood losses were 20, 10, 10, 50, and 20 ml respectively.The number of lymph node harvested was 12, 13, 15, 19, and 16.All distal tumor-free margins exceeded 5 cm.They were discharged without recorded complications.In the 1-year follow-up data, one was dead for pulmonary embolism in postoperative month 11, while other four were confirmed no recurrence and metastasis.Conclusions LESS colorecotmy performed above the pubic symphysis through a homemade glove access is safe and technically feasible, which can achieve the oncologic radical cure for rectosigmoid cancer.It possesses not only good minimally invasive advantages but also excellent cosmetic effects as well.
其他文献
目的:探讨吻合器痔上粘膜环切术(PPH术)治疗混合痔的手术前、后护理.方法:采用PPH术治疗174例严重混合痔患者,手术前心理护理,做好充分的肠道准备;手术后密切观察患者手术部位疼痛、出血情况以及尿潴留等并发症,给予正确的饮食指导和护理;出院时进行康复指导.结果:患者术中肠道清洁,术后无局部感染、水肿及明显的吻合口出血,术后6小时下床活动,平均住院3-7天,痊愈出院.结论:做好PPH术患者的围手术
目的:分析超声多普勒引导下痔动脉结扎术结合消痔灵注射治疗Ⅱ度内痔的临床疗效.方法:50例Ⅱ度内痔患者,采用超声多普勒引导下痔动脉结扎术结合消痔灵注射的方法治疗,与50例单纯采用超声多普勒引导下痔动脉结扎术进行随机对照.结果:两组术后肛门疼痛评分未见明显差异,肛门功能均正常,术后随访6-24个月,其出血和脱垂发生率及病人满意度情况,治疗组均明显优于对照组.结论:超声多普勒引导下痔动脉结扎术结合消痔灵
目的:尝试将目前最微创、微痛的治痔手术-超声多普勒痔动脉结扎术用于轻度的环状内痔脱垂伴出血的患者,通过追加内痔提吊术,同时解决患者的痔出血与脱垂问题.方法:对本组入选的32例脱垂内痔体积不很大的Ⅱ-Ⅲ期环状内痔伴出血的患者行在超声多勒引导下痔动脉结扎加内痔提吊术,并进行临床观察.结果:本组32例患者术后随访1-5个月,所有患者痔脱垂和出血症状都消失.且术后无直肠血肿、创口出血及创口感染发生;无肛门
目的:研究PPH联合吻合口多点缝合对减少混合痔PPH术后大出血的效果.方法:按标准随机选择106例患者分为治疗组与对照组,治疗组予以PPH联合吻合口多点缝扎,对照组予以PPH.观察比较两组手术术后吻合口大出血发生率、出血时间、出血量.结果:治疗组53例中发生大出血的有2例(3.8%),平均出血时间是术后6天,平均出血量为175ml;对照组53例中发生大出血的有5例(9.4%),平均出血时间是术后2
痔是临床常见病、多发病,临床上常见症状有出血、脱出、疼痛和肛门刺激症等表现,如果不及时治疗可导致贫血,嵌顿,影响生活质量.本文介绍了采用铜离子电化学疗法治疗痔经过大量临床观察是既安全有效又经济简便,既能减少痛苦、并发症,又可缩短术后恢复时间的低侵袭性外科治疗方法,并从三方面分析了其作用机制,铜作为一种微量金属元素经肠管吸收,分布到肠道粘膜细胞内,细胞内有两种结合铜的蛋白,酶分子中Cu2+浓度下降,
目的:探讨蒸发罨包疗法治疗混合痔术后并发症的疗效及总结护理要点.方法:将符合纳入标准的116例混合痔术后患者随机分为两组,观察组59例,对照组57例.罨包方按当归10g、赤芍10g、徐长卿10g、芒硝10g的水煎剂进行罨包的制作,同时准备好红外线治疗仪及生肌散.术后两组行相同的基础治疗,再每天两次使用生肌散换药后,观察组予45℃半干罨包一块外敷肛缘并予针对性的护理干预,对照组予红外线治疗仪照射肛缘
目的:痔探讨将超声刀运用于痔病手术的疗效.方法:自2010年4月到2013年4月,重庆其实医院肛肠科收集应用超声刀治疗痔病患者69例,参照(国家中医药管理局《中医肛肠科治疗标准》)评判疗效.结果:69例痔病患者全部治愈,住院时间最短5天,最长15天,平均10天.结论:超声刀应用在肛肠手术治疗具有止血可靠、创面平整、整形完美、价格相对低廉等优势,且从近期来看,其效果良好,但其远期疗效尚待进一步研究总
目的:探讨既能治愈马蹄形高位肛瘘又可以最大化地保护括约肌和肛门皮肤的新术式.方法:采用跳跃式接力切开加脱细胞真皮植入方法治疗高位蹄铁形肛瘘76例,并与传统方法进行随机对照.结果:跳跃式接力切开加脱细胞真皮植入方法在肛门控便能力、痊愈、愈合时间方面均优于传统方法(P<0.01~0.05).结论:跳跃式接力切开加脱细胞真皮植入方法治疗高位蹄铁形肛瘘,既能保证必要的显露,又避免了瘘道的大范围切开,维护了
胃肠道间质瘤(GIST)是最常见的胃肠道间叶细胞肿瘤,外科手术仍然是GIST治疗的最为基础有效的方式.本文主要阐述胃间质瘤的手术原则及手术方式的选择,以及伊马替尼靶向治疗在术前和术后的应用,为胃间质瘤的研究提供借鉴。
Background: Our previous studies of human breast and prostate cancer have shown that aberrant immune cell infiltration is associated with focal tumor capsule disruption and tumor cell budding that fac