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目的探讨手辅助腹腔镜(hand-assisted laparoscopic surgery,HALS)在结直肠癌手术中的临床应用。方法结合自2010～2011年2年间所开展的17例蓝碟装置手辅助腹腔镜结直肠癌手术,并查阅了相关的文献资料,总结分析手辅助腹腔镜技术在结直肠癌手术中的临床经验体会。结果 17例手术患者中,仅1例上段直肠癌因肿块浸润粘连严重予中转开放手术,其余16例患者均能顺利完成微创手术,未发生邻近脏器组织损伤。采用手辅助腹腔镜结直肠癌切除手术方式,手术时间较传统开腹手术时间延长并不明显,但手术创伤出血、术后疼痛及功能恢复等均较开放手术有明显优势。患者术后恢复快,并发症少。结论 HALS具有现代全腹腔镜手术和传统开腹手术的共同优点,是结直肠全腹腔镜手术的有力补充,有良好的应用前景。
Objective To investigate the clinical application of hand-assisted laparoscopic surgery (HALS) in colorectal cancer surgery. Methods A total of 17 cases assisted with laparoscopic colorectal cancer surgery assisted by blue dish device during the two years from 2010 to 2011 were reviewed. Relevant literatures were reviewed and the clinical experience of hand-assisted laparoscopy in colorectal cancer surgery was summarized. Experience. Results Of the 17 surgically treated patients, only one of the upper rectal cancers was severely interrupted by tumor invasion and operation. The remaining 16 patients were able to successfully complete the minimally invasive surgery without any adjacent organ tissue injury. Using hand assisted laparoscopic resection of colorectal cancer surgery, the operation time is longer than the traditional laparotomy is not obvious, but the surgical trauma bleeding, postoperative pain and functional recovery than open surgery has obvious advantages. Patients recover quickly, with fewer complications. Conclusions HALS has the common advantages of modern total laparoscopic surgery and traditional laparotomy and is a powerful supplement for total laparoscopic colorectal surgery. It has a good prospect of application.