【摘要】 目的探讨腹腔镜辅助下中低位直肠癌根治术的可行性。方法总结分析2008年10月至2011年4月收治并行腹腔镜直肠癌根治术的52例中低位直肠癌患者的临床资料。结果 52例患者均成功完成腹腔镜直肠癌根治术。手术时间(173.0±30.5)min,清扫淋巴结数目(13.0±4.4)个,肿瘤下切缘均为阴性,术中出血量(95.0±37.4)mL。术后胃肠功能恢复时间(3.0±1.7)d,住院时间(14.0±4.1)d。术后并发吻合口漏、腹部切口感染、会阴部切口感染各1例,发生排尿功能障碍2例,保守治疗后痊愈。43例术后随访1～42个月,腹腔转移1例,会阴部复发1例。结论腹腔镜直肠癌根治术安全可行,但须谨慎选择适应证,解决好全直肠系膜切除以及盆神经保护两大难点是手术成功的关键。更多还原

【Abstract】 Objective To investigate the feasibility of laparoscopic assisted radical resection of low rectal cancer.Methods The data of 52 cases of low rectal cancer subjected to laparoscopic assisted radical rectectomy during October 2008 to April 2011 were summarized.Results Laparoscopic assisted radical rectectomy was carried out in all cases successfully,the mean operative time was(173.0 ± 30.5) min,mean number of lymph nodes dissected was(13.0 ± 4.4) and mean blood loss was(95.0 ± 37.4) ml.All the distal margins were negative.The mean postoperative time of recovery of bowel function was(3.0 ± 1.7) d and mean hospitalization was(14.0 ± 4.1) d.Anastomotic fistula,abdominal wound infection and perineal wound infection occurred occurred in 1 case respectively,voiding dysfunction occurred in 2 cases.All the complications were cured by conservative treatment.43 cases were followed-up for 1-42 months,the results revealed peritoneal metastasis and perineal recurrence in 1 case respectively.Conclusions Laparoscopic assisted radical rectectomy is safe and feasible,however,the indications must be selected carefully and two difficult points,which include TME and PANP must be treated properly.更多还原