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目的 :探索腹腔镜全直肠系膜切除 (TME)大部直肠周围系膜切除 (MCME)、低位 /超低位 /结肠 -肛管吻合术治疗下段直肠癌的可行性。方法 :按TME原则、用双钉合技术 (DST) ,在腹腔镜下对 2 0例下段直肠癌患者实施TME、DST低位 /超低位吻合术。结果。 2 0例患者手术顺利 ,无中转开腹 ,手术时间 140分钟～ 32 0分钟 ,平均 185分钟 ;术中出血 5～ 80ml,平均 2 5ml;术后 1～ 2天恢复胃肠功能并下床活动 ,住院时间 5～ 14天 ,平均 9天。术后止痛剂应用 7例 ,术中及术后无并发症发生。结论 :腹腔镜TME/MCME、低位 /超低位 /结 -肛吻合术治疗下段直肠癌 ,创伤小、保肛率高、术后疼痛轻、恢复快 ,是一极具应用前景的微创新技术。
Objective : To explore the feasibility of laparoscopic total mesorectal excision (TME) for most of the rectal mesorectal excision (MCME) and low/ultra-low/colon-anal anastomosis for the treatment of lower rectal cancer. METHODS: TME and DST low/ultra low anastomosis were performed on 20 patients with lower rectal cancer according to TME principle and double staple technique (DST). result. Twenty patients underwent a successful operation without conversion to laparotomy. The operation time ranged from 140 minutes to 32 minutes with an average of 185 minutes. The intraoperative blood loss was 5 to 80 ml with an average of 25 ml. The gastrointestinal function and ambulation activity were restored within 1 to 2 days after operation. The hospital stay was 5 to 14 days, with an average of 9 days. Postoperative analgesic agents were used in 7 patients. No complications occurred during or after surgery. Conclusion: Laparoscopic TME/MCME, low/ultra-low/columocele-anastomosis for the treatment of lower rectal cancer is a promising micro-innovation technique with less trauma, high anus-preserving rate, less postoperative pain, and rapid recovery. .