论文部分内容阅读
目的评估腹腔镜结直肠肿瘤切除术(LCR)的可行性及安全性。方法分析2000年1月-2004年11月间36例行LCR的结直肠肿瘤患者的临床资料。结果34例LCR获得成功,其中腹腔镜右半结肠切除术2例,左半结肠切除术3例,乙状结肠切除术4例,Miles手术9例,Dixon手术15例,全结肠切除术1例。手术时间120～280(平均160)min,术中出血5～150(平均80)ml。中转开腹Dixon手术2例,术后并发肠梗阻2例,输尿管瘘1例,尿储留1例。术后随访15.7(1～36)个月,肿瘤复发3例,局部复发再手术1例,局部复发加肝内转移和门静脉瘤栓1例,右半结肠DukesC期术后1年腹腔内广泛转移1例。未发现穿刺孔种植。结论腹腔镜结直肠肿瘤切除术是可行和安全的、且近期疗效良好。
Objective To evaluate the feasibility and safety of laparoscopic colorectal tumor resection (LCR). Methods The clinical data of 36 colorectal cancer patients undergoing LCR between January 2000 and November 2004 were analyzed. Results 34 cases of LCR were successful, including laparoscopic right hemicolectomy in 2 cases, left hemicolectomy in 3 cases, sigmoid resection in 4 cases, Miles in 9 cases, Dixon in 15 cases, and total colectomy in 1 case. The operation time was 120 to 280 (average 160) minutes, intraoperative blood loss was 5 to 150 (average 80) ml. Two cases of Dixon were converted to laparotomy, and 2 cases had intestinal obstruction after operation, 1 case of ureteral fistula, and 1 case of urine retention. Follow-up was 15.7 (1 to 36) months after surgery. 3 cases of tumor recurrence, 1 case of local recurrence and reoperation, 1 case of local recurrence plus intrahepatic metastasis and portal vein tumor embolus, and 1 year of intrauterine peritoneal metastasis of Dukes C stage in the right colon. 1 case. No puncture hole was found. Conclusion Laparoscopic colorectal tumor resection is feasible and safe, and has good curative effect in the near future.