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目的探讨腹腔镜低位直肠癌根治腹部无切口经肛门切除标本套入式吻合保肛术手术配合方法及配合模式。方法对30例低位直肠癌经腹腔镜下根治腹部无切口经肛门切除标本行套入式吻合保肛术的手术配合,均采用统一的整体规范管理模式,四做到:术前访视患者、术前与手术医师沟通、术前熟悉解剖与手术程序、术前特殊仪器和器械准备。六配合:手术体位配合、气腹建立配合、上夹切断肠系膜下动静脉配合、游离直肠下段配合、肛门显露与切除标本配合、套入式吻合配合。结果本组30例低位直肠癌患者,平均手术时间为178 min,腹部手术时间约为132 min,经肛门套入式吻合操作时间46 min,术中无任何意外发生,无中转手术,均顺利完成手术。结论腹部无切口经肛门切除标本的腹腔镜低位直肠癌根治套入式吻合是一个创新手术,手术配合强调规范化,四做到、六配合模式是有效配合手术医师顺利完成手术的重要保证。
Objective To investigate the method and mode of operation for laparoscopic low rectal cancer with abdominal incision and anal resection. Methods Thirty patients with low rectal cancer underwent laparoscopic radical resection of abdomen without anastomosis and anastomosis underwent surgical operation. All of them adopted a unified overall standard management mode, Preoperative communication with the surgeon, preoperative anatomy and surgical procedures, preoperative special equipment and equipment preparation. Six with: surgical position with the establishment of pneumoperitoneum, on the folder to cut off the inferior mesenteric artery and vein with the lower rectal free, anal revealed and resected specimens, nesting anastomosis. Results In the 30 patients with low rectal cancer, the average operation time was 178 min, the abdominal operation time was about 132 min, and the transanal anastomosis operation time was 46 min. All the patients had no accidental operation during operation, surgery. Conclusions The laparoscopic radical rectal cancer radical nested anastomosis without incision and anus resection in the abdomen is an innovative operation. The operative coordination emphasizes the standardization and the four cooperation modes are the important guarantee for the successful completion of the operation with the surgeon.