【摘要】 目的探讨两孔法腹腔镜Ⅰ、Ⅱ期中高位直肠癌根治术的安全性和可行性。方法回顾性分析2018年1月～2019年6月两孔法腹腔镜手术治疗Ⅰ、Ⅱ期中高位直肠癌20例资料。肿瘤下缘距肛门6～12 cm,(8.95±1.87)cm。cTNM分期Ⅰ期13例,Ⅱ期7例。经脐或脐下缘做3 cm切口,安装单孔穿刺器,麦氏点处12 mm戳孔为术者主操作孔,完成直肠癌根治术后此孔放置引流管。结果 20例均顺利完成手术,无增加戳孔或中转开腹,手术时间(145.1±23.6)min,术中出血量(53.2±10.5)ml,排气时间(2.1±0.7)d,进食流质时间(3.2±0.4)d,盆腔引流时间(6.9±0.7)d,清扫淋巴结(14.5±1.9)枚,pTNM分期Ⅰ期13例,Ⅱ期7例。无吻合口及腹盆腔出血、吻合口漏、腹盆腔感染及肠梗阻等,术后住院时间(9.7±1.8)d。20例术后随访4～22个月,(8.3±4.7)月,均未见复发及转移。结论两孔法腹腔镜Ⅰ、Ⅱ期中高位直肠癌根治术安全可行。更多还原

【Abstract】 Objective To explore the safety and feasibility of dual-port laparoscopy for middle and high rectal carcinoma at stage Ⅰ/Ⅱ. Methods A retrospective analysis was made on 20 cases with rectal carcinoma at stage Ⅰ/Ⅱ treated by dual-port laparoscopic surgery from January 2018 to June 2019. The lesions had a distance of 6-12(8.95±1.87) cm from the lower edge of the tumor to the anus. There were 13 cases of cTNM stage Ⅰ and 7 cases of stage Ⅱ. A 3-cm incision was made through the umbilicus or the lower edge of the umbilicus, and a single-port puncture device was installed. A 12-mm trocar at McBurney’s point was used as the main operation port of the operator, and a drainage tube was placed through this port after radical resection of rectal carcinoma.Results All the operations had been successfully completed without need of additional port or conversion to laparotomy. The average operation time was(145.1±23.6) min; the intraoperative blood loss was(53.2±10.5) ml; the first postoperative exhaust time was(2.1±0.7) d; the time of feeding fluid was(3.2±0.4) d; the time of pulling out pelvic drainage tube was(6.9±0.7) d; the number of lymph nodes resected was(14.5±1.9); the pTNM stage was 13 cases at stage Ⅰ and 7 cases at stage Ⅱ. There were no anastomotic and pelvic bleeding, anastomotic leakage, abdominal and pelvic infection, or intestinal obstruction. The average postoperative hospital stay was(9.7±1.8) d. All the 20 cases were followed up for 4-22(8.3±4.7) months. No relapse or metastasis was found. Conclusion Dual-port laparoscopic surgery is safe and feasible in radical resection of middle and high rectal carcinoma at stage Ⅰ/Ⅱ.更多还原