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目的:探讨腹腔镜手术在结肠直肠肿瘤切除术中的应用和临床效果。方法:利用腹腔镜技术对109例结肠直肠肿瘤病人进行手术,并对手术操作、术后情况以及并发症等进行分析。结果:109例病人中转开腹手术11例,占10.1%。98例采用腹腔镜方法完成手术切除,其中结肠直肠腺瘤3例,结肠直肠癌95例。95例结肠直肠癌行姑息性切除5例,根治性切除90例;术式为Miles手术31例,右半结肠切除27例,乙状结肠切除18例,前切除16例,降结肠切除2例,横结肠切除1例。本组病人术中无其他脏器损伤、大出血、气体栓塞等发生,术后无因出现并发症而行再手术治疗者,无一例死亡。在进行根治性切除并达到术后半年以上的病人中,目前有局部复发1例,肝和肺转移各1例,术后复发转移率为5.7%。目前尚未发现有腹壁切口和穿刺孔转移。结论:腹腔镜结肠直肠肿瘤切除手术创伤小,安全、可行,具有广阔的推广应用前景。
Objective: To investigate the application and clinical effect of laparoscopic surgery in colorectal tumor resection. Methods: 109 patients with colorectal neoplasms were treated by laparoscopy, and the operation, postoperative complications and complications were analyzed. Results: 109 cases were converted to open surgery in 11 cases, accounting for 10.1%. 98 patients underwent laparoscopic resection, of which 3 cases of colorectal adenoma and 95 cases of colorectal cancer. 95 cases of colorectal cancer were treated with palliative resection in 5 cases and radical resection in 90 cases. The procedure was Miles operation in 31 cases, right colon resection in 27 cases, sigmoid colon resection in 18 cases, anterior resection in 16 cases, descending colon resection in 2 cases, transverse colon Excision of 1 case. No other organ damage, bleeding, gas embolism, etc. occurred in this group of patients during operation. No other patients died after surgery due to complications. In the radical resection and to achieve more than six months after surgery, there are 1 cases of local recurrence, liver and lung metastasis in 1 case, postoperative recurrence and metastasis rate was 5.7%. No abdominal incision or puncture hole has been found yet. Conclusions: Laparoscopic colorectal tumor resection has the advantages of less trauma, safety and feasibility, and has broad prospect of popularization and application.