论文部分内容阅读
目的探讨腹腔镜辅助下结直肠癌手术的可行性、安全性、并发症及近期临床疗效。方法回顾性分析4年间1 1 2例腹腔镜下结直肠癌手术患者的临床资料,包括右半结肠切除2 3例,左半结肠切除7例,乙状结肠癌切除1 5例,D ixon术4 9例,M iles术1 8例。结果1 0 5例手术成功,7例因出血、肥胖及与邻近器官粘连而中转开腹手术,其中左半结肠2例,直肠癌4例。平均手术时间(1 6 1.2±4 8.6)m in,平均出血量7 8.5mL。术后早期并发症8例,无围手术期死亡。结肠癌标本近、远切缘长度分别为(1 4.5±3.2)cm和(1 1.0±2.6)cm,直肠癌标本近、远切缘长度分别为(15.3±2.7)cm和(2.8±1.6)cm。清扫淋巴结平均(8.2±4.6)枚,4 9例淋巴结转移。随访8~4 4个月,随访率9 5.5%。随访未发现戳孔肿瘤种植,局部复发7例(6.5%),远处转移6例(5.6%),总病死率7.5%(8/1 0 7)。结论腹腔镜下结直肠癌手术不仅安全可行,具有微创优势,并可达到与开腹同样的肿瘤根治性效果。
Objective To investigate the feasibility, safety, complications and short-term clinical efficacy of laparoscopic-assisted colorectal cancer surgery. Methods The clinical data of 112 patients undergoing laparoscopic surgery for colorectal cancer over a four-year period were analyzed retrospectively. The data included 23 cases of right colon resection, 7 cases of left colon resection, 15 cases of sigmoid colon resection, and 9 cases of Dixon surgery Cases, M iles surgery 18 cases. Results One hundred and five cases were successfully surgically treated. Seven cases underwent laparotomy due to hemorrhage, obesity and adhesions with neighboring organs. Among them, there were 2 cases of left colon and 4 cases of rectal cancer. The average operation time was (16.2 ± 8.66) mins, the average amount of bleeding was 7 8.5mL. 8 cases of early postoperative complications, no perioperative deaths. The lengths of the proximal and distal margin of colon cancer specimens were (14.5 ± 3.2) cm and (1.0 ± 2.6) cm, respectively. The lengths of distal and distal margin of colon cancer specimens were (15.3 ± 2.7) cm and (2.8 ± 1.6) cm. The average number of dissected lymph nodes (8.2 ± 4.6), 49 cases of lymph node metastasis. The follow-up ranged from 8 to 44 months, with a follow-up rate of 9 5.5%. Seven patients (6.5%) had local recurrence, six patients (5.6%) had distant metastasis, and the total case fatality rate was 7.5% (8/1 0 7). Conclusions Laparoscopic surgery for colorectal cancer is not only safe and feasible, but also has the advantage of minimally invasive operation and achieves the same radical curative effect as open laparoscopy.